Magnification chromoendoscopy for the detection of intestinal metaplasia and dysplasia in Barrett's esophagus
2001; Elsevier BV; Volume: 53; Issue: 5 Linguagem: Inglês
10.1016/s0016-5107(01)80026-2
ISSN1097-6779
AutoresMahesh S. Mokhashi, Tammy Glenn, Christian Jöst, Michael B. Wallace, Christopher Kim, Johnson Va, M. Berdan CTR, Robert L. Johnson, Bora Gumustop, Peter B. Cotton, Robert H. Hawes,
Tópico(s)Metastasis and carcinoma case studies
ResumoIntro:Diagnostic accuracy of esophagoscopy with a 3.1 mm prototype BPE (Olympus XEF-DP) is good, when performed with sedation & is cost-effective in screening for Barrett's (AJG 2000;95(9):2440-1).Alms:In a prospective blinded study, compare the diagnostic accuracy & tolerance of unsedatedesophagoscopy with a BPE with a sedated SVE.Methods:96 pts.were recruited to have unsedated esophagoscopy with BPE foil.by SVE, by 2 MDs, each blinded to the findings of the other.For the BPE, pts.were randomized to either the oral or nasal route.On a visual analogue scale, pts.rated their amxiety & tolerance; MDs rated pt.tolerance & scope performance.Results: 96 pts.(M-81; mean age 56 yr) were analyzed.Mean duration of esophagoscopy was 4.1 rain (range 1.5 7 min).Sensitivity : specificity (%) with BPE was 95:100 (Barrett's) & 80:96 (other lesions).Only belching was more with BPE (87:96, p < 0.0001).All other pt.tolerance parameters evaluated by the MDs(intubation, gagging, coughing, defense reactions, pt.collaboration) were not different.95% pts.were willing to repeat the BPE under similar circumstances.Tolerance, willingness to repeat the BPE were not different when the nasal & oral routes were compared.Measures of scope performance were better with S\rE (BPE:SVE, p value): visibility 91:99, 0.0001; air insufflation 90:99, 0.0001; maneuverability 88:99,0.0001.Conclusion: Unsedated esophagoscopy with a 3.1 mm BPE is well tolerated and can be completed in a short time.It is highly accurate as a screening tool for Barretts esophagus. Esophageal findings SVE BPE
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