Evolution of Barrett’s Assessment in a Tertiary Referral Center Over Time

Aims Barrett’s oesophagus is associated with 24 fold increase in risk of Oesophageal cancer. Seattle biopsy protocol is gold standard in Barrett’s surveillance. Adherence to Seattle protocol increases dysplasia detection rate (DDR). In addition, the inclusion of chromoendoscopy with Narrow band imaging (NBI) and Acetic Acid spray (AA) is also associated with improved dysplasia detection rate. Our aim was to review how our assessment of Barrett’s oesophagus with regards to the use of chromoendoscopy, adherence to Seattle Protocol and documentation of Prague classification has evolved over time at our institute and if dysplasia detection rate improved concomitantly.

Methods It was a retrospective study. First 50 patients with Barrett’s oesophagus at 3 different time points (2013, 2016, 2019) were included. Data of consecutive 50 patients from each year was retrieved through electronic database. Patients with known dysplasia, prior treatment for dysplasia and contraindication for biopsy were excluded.

Results A total of 150 patients were included in the study. Mean age 65 (66 % males). Documentation of Prague classification increased from 50 % (2013) to 94 % (2019) while Seattle protocol adherence increased from 56 % (2013) to 89.6 % (2019). Seattle Protocol adherence in short segment Barrett’s (SSBE) improved from 50 % (2013) to 94.7 % (2019) and in long segment Barretts (LSBE) from 62.5 %(2013) to 86.2 % (2019). Dysplasia detection rate increased from 8 % (2013) to 18 % (2019) and was higher in long segment (16 %) than short segment (2 %). Also use of Chromoendoscopy has increased from 0 % AA,& 4 %NBI (2013) to 62 % & 86 % (2019).

Conclusions Our study showed improvement in adherence to Seattle protocol, use of chromoendoscopy and dysplasia detection rate over time.

Citation: Rasool J, Janjua F, Aoko O et al. eP19 EVOLUTION OF BARRETT’S ASSESSMENT IN A TERTIARY REFERRAL CENTER OVER TIME. Endoscopy 2021; 53: S103.

Publication History

Article published online:
19 March 2021