Unsedated transnasal endoscopy accurately detects Barrett's metaplasia and dysplasia.
Publication/Presentation Date
10-1-2002
Abstract
BACKGROUND: Unsedated transnasal upper endoscopy has a diagnostic yield comparable with that of sedated conventional upper endoscopy. The ability of transnasal upper endoscopy to detect Barrett's metaplasia or dysplastic change has not been systematically evaluated. The aim of this study was to assess the feasibility of transnasal upper endoscopy for surveillance of patients with Barrett's esophagus and to evaluate its histopathologic yield for Barrett's metaplasia and dysplasia.
METHODS: Thirty-two patients with Barrett's esophagus were evaluated with conventional upper endoscopy and transnasal upper endoscopy. An effort was made to recruit patients known to have dysplasia. Quadrantic biopsy specimens were taken with standard (conventional upper endoscopy) and pediatric (transnasal upper endoscopy) biopsy forceps at procedures performed at least 1 week apart. Two blinded pathologists evaluated the specimens.
RESULTS: Transnasal upper endoscopy detected Barrett's metaplasia histopathologically in 31 of 32 patients. Level of agreement for presence of dysplasia in biopsy specimens obtained between conventional upper endoscopy and transnasal upper endoscopy was excellent (k = 0.79). Interobserver agreement for dysplasia in specimens obtained by conventional upper endoscopy (k = 0.61) and by transnasal upper endoscopy (k = 0.61) were similar. Intraobserver agreement between conventional upper endoscopy and transnasal upper endoscopy biopsy specimens for dysplasia by pathologist 1 (k = 0.73) and pathologist 2 (k = 0.75) were also similar. No significant adverse effects were noted.
CONCLUSIONS: Transnasal upper endoscopy is feasible and accurate for identification and histopathologic confirmation of Barrett's metaplasia with a histopathologic yield for dysplasia comparable with conventional upper endoscopy.
Volume
56
Issue
4
First Page
472
Last Page
478
ISSN
0016-5107
Published In/Presented At
Saeian, K., Staff, D. M., Vasilopoulos, S., Townsend, W. F., Almagro, U. A., Komorowski, R. A., Choi, H., & Shaker, R. (2002). Unsedated transnasal endoscopy accurately detects Barrett's metaplasia and dysplasia. Gastrointestinal endoscopy, 56(4), 472–478. https://doi.org/10.1067/mge.2002.128131
Disciplines
Medicine and Health Sciences
PubMedID
12297760
Department(s)
Department of Medicine
Document Type
Article