Title: Optimization of the diagnosis, management and treatment of patients with different types of Barrett’s esophagus. The results of our own observations
Abstract:Objective — to optimize the diagnostic methods, concepts of definitions and treatment options in patients with different types of Barrett’s esophagus, as well as to standardize endoscopic observation ...Objective — to optimize the diagnostic methods, concepts of definitions and treatment options in patients with different types of Barrett’s esophagus, as well as to standardize endoscopic observation intervals for these patients.Materials and methods. The material of the study was the results of instrumental studies and treatment data of 22 patients with Barrett’s esophagus without dysplasia, with «indefinite» for dysplasia, low‑grade dysplasia (LGD) and high‑grade dysplasia (HGD). The most part of patients (17 (77.3 %)) referred to the age group of 33 to 43 years (the mean age (38.5 ± 0.4) years). The diagnosis was verified on the basis of the data of instrumental and morphological investigations.Results. Among the 22 examined patients with diagnosed Barrett’s esophagus, 10 (45.5 %) patients were diagnosed with Barrett’s esophagus without dysplasia, in 7 patients (31.8 %) — Barrett’s esophagus with «indefinite» for dysplasia, in 4 patients (18, 2 %) — Barrett’s esophagus with LGD, in 1 patient (4.5 %) — Barrett’s esophagus with HGD. The H. pylori tests were negative in 13 patients. Other patients haв anamnesis of the successful eradication therapy. The unique algorithm of the management of patients with different EB types has been worked out.Conclusions. The absence of H. pylori infection or the successful completion of previous eradication therapy does not reduce the risk of dysplasia in the Barrett’s esophagus segment. Barrett’s esophagus is an endoscopic diagnosis, only if the examination is performed with a high‑resolution endoscope (HD endoscopy) with magnification and chromoscopy, which is further confirmed morphologically. Continuous administration of PPIs for Barrett’s esophagus without dysplasia, with a segment size of Barrett’s esophagus less than 3 cm, in asymptomatic patients and without a family history of cancer, probably requires revision.Read More
Publication Year: 2020
Publication Date: 2020-12-05
Language: en
Type: article
Indexed In: ['crossref']
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