Article Text
Abstract
Introduction A dedicated endoscopy list for Barrett’s surveillance was introduced at our hospital from 2010. In this study we compared the rate of dysplasia detection and targeted biopsy of this approach with Barrett’s surveillance on a general endoscopy list.
Methods In the dedicated list, all endoscopies were performed by a specific gastroenterologist who has an interest in Barrett’s oesophagus using a combination of high resolution white light magnification, auto fluorescence and narrow band imaging. This was in contrast to the practise of previous years where the endoscopies for Barrett’s surveillance were done by a physician gastroenterologist, a surgeon, or a nurse endoscopist using conventional white light endoscopy alone. In this study, we compared the detection rate of high grade dysplasia, low grade dysplasia and targeted biopsy between patients who underwent endoscopy on a dedicated list and those who underwent surveillance on a general endoscopy list.
Results In group 1 were 151 endoscopies performed on a general list during the years 2008–2009, which were compared with 87 endoscopies performed on a dedicated list from 2010 to 2011. Only one targeted biopsy was taken in group 1 compared to 17 targeted biopsies in group2. The detection rate of high grade dysplasia, low grade dysplasia and all dysplasia were greater in group2 compared to group1. However we were not able to detect a statistically significant difference in rates between the two groups. On the other hand, the difference in the rates of targeted biopsies between the two groups was found to be statistically significant The difference in detection rates between the two groups [–18.88, 95% CI –26.13 – –11.62, p = < 0.0001]. Three of the four high grade dysplasia were detected on a targeted biopsy and two of them had a cancer in situ.
Conclusion In this retrospective comparative study we were able to demonstrate that a dedicated Barrett’s surveillance endoscopy list is able to generate a significantly greater number of targeted biopsies compared to surveillance endoscopy performed on varied general lists. The detection rates of high grade dysplasia, low grade dysplasia and all dysplasia were greater on the dedicated list, although this did not reach statistical significance. We would therefore recommend a dedicated Barrett’s surveillance endoscopy list
Disclosure of Interest None Declared