ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus.
ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus.
复制标题
DOI：
10.1038/ajg.2015.322
复制
发表时间：
2016-01
影响因子：
9.8
通讯作者：
Gerson, Lauren B.
中科院分区：
文献类型：
--
作者：
Shaheen, Nicholas J.;Falk, Gary W.;Iyer, Prasad G.;Gerson, Lauren B.
巴雷特食道(BE)是胃肠病医生最常见的疾病之一。在这份文件中，美国胃肠病学会更新了护理这些患者的最佳实践指南。这些指南继续支持对BE高危患者的筛查；然而，常规筛查仅限于有反流症状和多种其他危险因素的男性。考虑到最近关于非发育不良BE患者恶性进展风险低的数据，在这一人群中，内窥镜监测间隔时间缩短；非发育不良BE患者接受内窥镜监测的频率不应超过每3-5年一次。目前不推荐常规使用生物标记物面板或先进的内窥镜成像技术(超越高清晰度内窥镜检查)。对于BE和高度不典型增生以及T1a食管腺癌的患者，推荐进行内窥镜下消融治疗。根据最近的1级证据，内窥镜消融治疗也被推荐用于BE和低级别异型增生的患者，尽管内窥镜监测仍然是一种可接受的替代方案。鉴于消融后BE的复发相对常见，我们建议消融后的内窥镜检查间隔时间。虽然所提供的许多建议都是基于薄弱的证据或专家意见，但本文件为BE患者的护理提供了一个实用的框架。
Barrett’s esophagus (BE) is among the most common conditions encountered by the gastroenterologist. In this document, the American College of Gastroenterology updates its guidance for the best practices in caring for these patients. These guidelines continue to endorse screening of high-risk patients for BE; however, routine screening is limited to men with reflux symptoms and multiple other risk factors. Acknowledging recent data on the low risk of malignant progression in patients with nondysplastic BE, endoscopic surveillance intervals are attenuated in this population; patients with nondysplastic BE should undergo endoscopic surveillance no more frequently than every 3–5 years. Neither routine use of biomarker panels nor advanced endoscopic imaging techniques (beyond high-definition endoscopy) is recommended at this time. Endoscopic ablative therapy is recommended for patients with BE and high-grade dysplasia, as well as T1a esophageal adenocarcinoma. Based on recent level 1 evidence, endoscopic ablative therapy is also recommended for patients with BE and low-grade dysplasia, although endoscopic surveillance continues to be an acceptable alternative. Given the relatively common recurrence of BE after ablation, we suggest postablation endoscopic surveillance intervals. Although many of the recommendations provided are based on weak evidence or expert opinion, this document provides a pragmatic framework for the care of the patient with BE.
登录
查看更多内容
影响因子：
24.5
作者：
Bhat, Shivaram K.;McManus, Damian T.;Murray, Liam J.
通讯作者：
Murray, Liam J.
影响因子：
7.7
作者：
Badreddine, Rami J.;Prasad, Ganapathy A.;Wang, Kenneth K.;Song, Louis M. Wong Kee;Buttar, Navtej S.;Dunagan, Kelly T.;Lutzke, Lori S.;Borkenhagen, Lynn S.
通讯作者：
Borkenhagen, Lynn S.
影响因子：
7.7
作者：
Alikhan, M;Rex, D;Ulbright, TM
通讯作者：
Ulbright, TM
影响因子：
12.6
作者：
Anaparthy, Rajeswari;Gaddam, Srinivas;Sharma, Prateek
通讯作者：
Sharma, Prateek
影响因子：
29.4
作者：
Anderson, Lesley A.;Cantwell, Marie M.;Murray, Liam J.
通讯作者：
Murray, Liam J.