Endoscopy 2007; 39(9): 840-842
DOI: 10.1055/s-2007-966653
Guidelines

© Georg Thieme Verlag KG Stuttgart · New York

French Society of Digestive Endoscopy SFED guideline: monitoring of patients with Barrett’s esophagus

J.  Boyer, R.  Laugier, M.  Chemali, J.  P.  Arpurt, C.  Boustière, J.  M.  Canard, P.  A.  Dalbies, G.  Gay, J.  Escourrou, B.  Napoléon, L.  Palazzo, T.  Ponchon, B.  Richard-Mollard, D.  Sautereau, G.  Tucat, B.  Vedrenne
Further Information

Publication History

Publication Date:
17 August 2007 (online)

Definitions

Diagnosis of Barrett’s esophagus, also known as Barrett’s mucosa, is by two means, endoscopic and histologic. Endoscopically, the condition is defined as a columnar epithelium that extends above the gastroesophageal junction (GEJ); histologically, it is defined by the presence of a specialized intestinal metaplasia.

Barrett’s esophagus is classified into three types according to its length:

Long-segment Barrett’s esophagus: when the distance between the GEJ and the squamocolumnar epithelial line (Z-line) is more than 3 cm long. Short-segment Barrett’s esophagus: when the distance between the GEJ and the Z-line is from 5 mm to 3 cm long. It may be circular like a sleeve or segmented into tongue(s). Ultra-short-segment Barrett’s esophagus: when the distance between the GEJ and the Z-line is less than 5 mm long. This entity cannot be diagnosed endoscopically since it cannot be distinguished from the cardial intestinal metaplasia.

References

  • 1 Boyce H W. Endoscopic definitions of oesogastric junction regional anatomy.  Gastrointest Endosc. 2000;  51 586-592
  • 2 Boyer J. Aspects cliniques et endoscopiques de l’oesophage de Barrett.  Gastroentol Clin Biol. 1994;  18 D5-11
  • 3 Chalasani N, WO J M, Hunter J C. et al . Significance of intestinal metaplasia in different areas of oesophagus including oesogastric junction.  Dig Dis Sci. 1997;  42 603-607
  • 4 Dulai G S, Shekelle P G, Jensen D M. et al . Dyplasia and risk of further neoplastic progression in a regional veterans administrations Barrett’s cohort.  Am J Gastroenterol. 2005;  100 775-783
  • 5 Levine D S, Reid B J. Endoscopic biopsy technique for acquiring larger mucosal samples.  Gastrointest Endosc. 1991;  37 332-337
  • 6 Levine D S. Haggitt RC, Blount PL. An endoscopic protocol can differentiate high-grade dysplasia from early adenocarcinoma in Barrett’s oesophagus.  Gastroenterology. 1993;  105 40-50
  • 7 McClave S A, Boyce H W, Gottfried M R. et al . Early diagnosis of columnar-lined oesophagus: a new endoscopic criterion.  Gastrointest Endosc. 1987;  33 413-416
  • 8 Provenzale D, Shmitt C, Wong J B. Barrett’s esophagus: a new look at surveillance based on emerging estimates of cancer risk.  Am J Gastroenterol. 1999;  94 2043-2053
  • 9 Reaud S, Croue A, Boyer J. Diagnostic accuracy of magnifiying chromoendoscopy with detection of intestinal metaplasia and dysplasia using acetic acid in Barrett’s esophagus.  Gastroenterol Clin Biol.. 2006;  30 217-223
  • 10 Rudolph R E, Vaughan T L, Storer B E. et al . Effect of segment length on risk of neoplastic progression in patients with Barrett’s oesophagus.  Ann Intern Med. 2000;  132 612-620
  • 11 Sampliner R E. Updated guidelines for the diagnosis, surveillance, and therapy of Barrett’s oesophagus.  Am J Gastroenterol.. 2002;  97 1888-1895
  • 12 Schnell T G, Sontang S J, Chejfec G. et al . Long term non-surgical management of Barrett’s esophagus with high-grade dysplasia.  Gastroenterology. 2001;  120 1607-1619
  • 13 Sharma P, Morales T G, Sampliner R E. et al . Short segment Barrett’s oesophagus: the need for standardization of the definition and diagnostic criteria.  Am J Gastroenterol. 1998;  93 1033-1036
  • 14 Skacel M, Petras R E, Gramlich T L. et al . The diagnosis of low-grade dysplasia in Barrett’s oesophagus and its implications for disease progression.  Am J gastroenterol. 2000;  95 3383-3387
  • 15 Thomas T, Richards C J, De Caestecker J S. et al . High-grade dysplasia in Barrett’s oesophagus: natural history and review of clinical practice.  Aliment Pharmacol Ther. 2005;  21 747-755
  • 16 Weston A P, Krmpotich P T, Cherian R. et al . Prospective long term endoscopic and histologic follow-up of short segment Barrett’s oesophagus: comparison with traditional long segment Barrett’s oesophagus.  Am J Gastroenterol.. 1997;  92 407-413
  • 17 Weston A P, Sharma P, Mathur S. et al . Risk stratification of Barrett’s esophagus: Updated prospective multivariate analysis.  Am J Gastroenterol. 2004;  99 1657-1666

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