Surveillance in Barrett's esophagus: an audit of practice.

摘要: Determine the rates of follow-up, incident rate cancer during surveillance, and changes in pathologic grade patients with Barrett’s esophagus surveillance a gastroenterology practice without formal program. is pre-malignant condition. Surveillance endoscopy (SE) recommended order to detect treat high-grade dysplasia esophageal adenocarcinoma early prevent deaths. SE has not been shown have mortality benefit several studies questioned its cost-effectiveness. Most practices do program for esophagus. The few that exist are only very specialized funded programs. Little information exists on outcomes outside these well-structured A retrospective analysis cohort diagnosed surveyed between 1995 2005 at Veterans Affairs medical center. Data were collected age, body mass index, race. Patients who missed their by 6 months or more those twice intervals identified analyzed grades. total 472 had 2005. Three hundred five one biopsy. They did follow-up endoscopies biopsies. Two excluded from final analysis: an esophagectomy after index diagnosis dysplasia, 2 days initial impression There 165 metaplasia than once included analysis. Overall, 53.3% no change grade, 35.2% regressed lower 11.5% progressed higher grade. None (0/165, 0%) adenocarcinoma; 3.6% (6/165) (19/165) normal mucosa. Forty-four more. Of these, 50% regressed, 40.9% change, 9.1% progressed. Four mucosa, none adenocarcinoma. Twenty-three 60.9% 34.8% 4.3% but three After adjusting age low-grade nearly seven times likely miss (OR 6.56, P-value 0.03). veteran undergo endoscopies. Veteran undergoing rarely progress longer up because they scheduled worse outcome when compared general group. most more, though reason this unknown.