Randomized crossover study comparing efficacy of transnasal endoscopy with that of standard endoscopy to detect Barrett's esophagus

Shariff, Kareem; Bird‐Lieberman, Elizabeth; O’Donovan, Maria; Abdullahi, Zarah; Liu, Xinxue; Blazeby, Jane; Fitzgerald, Rebecca C.

doi:10.1016/j.gie.2012.01.029

Cited by 100 publications

(101 citation statements)

References 51 publications

(58 reference statements)

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“…Conventional endoscopy is regarded as the gold standard despite evidence on limitations of accuracy. uTNE as an alternate modality for BE screening has been found to have comparable performance characteristics to endoscopy for the diagnosis of BE (sensitivity 98% and specifi city 100%) ( 90 ). Th e feasibility and safety of uTNE in BE screening in the community has also been demonstrated ( 75,77 ).…”

Section: Surveillance Of Bementioning

confidence: 97%

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Shaheen

Falk

Iyer

et al. 2016

American Journal of Gastroenterology

1,355

1,412

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Recent population studies suggest that gastroesophageal refl ux disease (GERD) is increasing in prevalence, both in the United States and worldwide ( 1,2 ). Th e diagnosis of GERD is associated with a 10-15% risk of Barrett's esophagus (BE), a change of the normal squamous epithelium of the distal esophagus to a columnar-lined intestinal metaplasia (IM). Risk factors associated with the development of BE include long-standing GERD, male gender, central obesity ( 3 ), and age over 50 years ( 4,5 ). Th e goal of a screening and surveillance program for BE is to identify individuals at risk for progression to esophageal adenocarcinoma (EAC), a malignancy that has been increasing in incidence since the 1970s ( 6,7 ).Th e purpose of this guideline is to review the defi nition and epidemiology of BE, available screening modalities for BE detection, rationale and methods for surveillance, and available treatment modalities including medical, endoscopic, and surgical techniques. In order to evaluate the level of evidence and strength of recommendations, we used the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system ( 8 ). Th e level of evidence ranged from "high" (implying that further research was unlikely to change the authors' confi dence in the estimate of the eff ect) to "moderate" (further research would be likely to have an impact on the confi dence in the estimate of eff ect) to "low" (further research would be expected to have an important impact on the confi dence in the estimate of the eff ect and would be likely to change the estimate) or "very low" (any estimate of eff ect is very uncertain). Th e strength of a recommendation was graded as "strong" when the desirable eff ects of an intervention clearly outweighed the undesirable eff ects and as "conditional" when there was uncertainty about the tradeoff s. We used meta-analyses or systematic reviews when available, followed by clinical trials and cohort and case-control studies. In order to determine the level Barrett's esophagus (BE) is among the most common conditions encountered by the gastroenterologist. In this document, the American College of Gastroenterology updates its guidance for the best practices in caring for these patients. These guidelines continue to endorse screening of high-risk patients for BE; however, routine screening is limited to men with refl ux symptoms and multiple other risk factors. Acknowledging recent data on the low risk of malignant progression in patients with nondysplastic BE, endoscopic surveillance intervals are attenuated in this population; patients with nondysplastic BE should undergo endoscopic surveillance no more frequently than every 3-5 years. Neither routine use of biomarker panels nor advanced endoscopic imaging techniques (beyond high-defi nition endoscopy) is recommended at this time. Endoscopic ablative therapy is recommended for patients with BE and high-grade dysplasia, as well as T1a esophageal adenocarcinoma. Based on recent level 1 evidence, endoscopic ablative therapy is ...

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Section: Surveillance Of Bementioning

confidence: 97%

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Shaheen

Falk

Iyer

et al. 2016

American Journal of Gastroenterology

1,355

1,412

View full text Add to dashboard Cite

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“…Over the last years, several noninvasive or minimally invasive methods have been proposed as alternatives to conventional EGD for the diagnosis of esophageal diseases, such as esophageal capsule endoscopy (ECE) and ultra-thin small caliber esophagoscopes [7][8][9][10][11][12] . Several studies have shown that ECE is safe and has an acceptable accuracy for the evaluation of esophageal varices and can be used as an alternative to EGD for the screening of portal hypertension, especially in patients unable or unwilling to undergo EGD [7,9] .…”

Section: Introductionmentioning

confidence: 99%

Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

Aedo

Zavala-González

Meixueiro-Daza

et al. 2014

WJGE

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AIM:To assess feasibility of unsedated esophagoscopy using a small-caliber disposable transnasal esophagoscopy and to compare its accuracy with standard endoscopy. METHODS:We prospectively included subjects who were referred for upper endoscopy. All subjects underwent transnasal endoscopy with E.G. Scan™. The disposable probe has a 3.6 mm gauge and at its distal end there is a 6 mm optical capsule, with a viewing angle of 125°. Patients underwent conventional endoscopy after the completion of E.G. Scan™. We describe the findings detected by the E.G. Scan™ and calculate the diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value and Kappa index for esophageal diagnosis. RESULTS:A total of 96 patients (54 women), mean age of 50.12 years (14 to 79), were evaluated. In all cases we were able to perform esophagoscopy with E.G.Scan™. The average realization time was 5 min. A total of 58 alterations were detected in the esophagus, 49 gastric abnormalities and 13 duodenal abnormalities. We found that for esophageal varices, E.G. Scan™ has sensitivity, specificity and diagnostic accuracy of 95%, 97% and 97%, respectively. Kappa coefficients were 0.32 for hiatal hernia, 0.409 for erosive gastroesophageal reflux disease, 0.617 for Barrett's esophagus, and 0.909 for esophageal varices. CONCLUSION:Esophagoscopy with E.G. Scan™ is a well-tolerated, fast and safe procedure. It has an appropriate diagnostic accuracy for esophageal varices when compared with conventional endoscopy.

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“…TNE can be performed in an office setting without sedation. Studies have demonstrated that TNE provides acceptable image quality and biopsies that, while small in size, are still sufficient for acceptable histologic analysis (13,14). TNE is also generally preferred by patients and is associated with less patient anxiety than conventional EGD.…”

Section: Screening For Bementioning

confidence: 99%

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

Mansour

El–Serag

Anandasabapathy

2017

Ann. Cardiothorac. Surg.

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Barrett's esophagus (BE) is a premalignant condition that increases the risk of esophageal adenocarcinoma (EAC). Significantly more common in the Western world, risk factors include increased age, male sex, white race, gastro-esophageal reflux disease (GERD), central obesity, and cigarette smoking. The rates of progression to cancer depend on the grade of Barrett's dysplasia. Screening for BE is recommended in patients with GERD and additional risk factors. Endoscopic surveillance of patients with BE likely improves overall outcomes. Advanced endoscopic imaging can help increase the efficiency of current endoscopic surveillance.Endoscopic therapy is safe and effective for the treatment of dysplastic BE and intramucosal EAC, but ongoing surveillance following treatment is necessary. This review will cover screening, surveillance, advanced imaging, chemoprevention, endoscopic treatment, and post-treatment surveillance of BE.

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Randomized crossover study comparing efficacy of transnasal endoscopy with that of standard endoscopy to detect Barrett's esophagus

Cited by 100 publications

References 51 publications

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus

Accuracy of transnasal endoscopy with a disposable esophagoscope compared to conventional endoscopy

Barrett’s esophagus: best practices for treatment and post-treatment surveillance

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