Background: Little is known on practice patterns of endoscopists for the management of Barrett's esophagus (BE) over the last decade.
Aims: Our aim was to assess practice patterns of endoscopists for the diagnosis, surveillance and treatment of BE.
Methods: All members of the Italian Society of Digestive Endoscopy (SIED) were invited to participate to a questionnaire-based survey. The questionnaire included questions on demographic and professional characteristics, and on diagnosis and management strategies for BE.
Results: Of the 883 SIED members, 259 (31.1%) completed the questionnaire. Of these, 73% were males, 42.9% had > 50 years of age and 68.7% practiced in community hospitals. The majority (82.9%) of participants stated to use the Prague classification; however 34.5% did not use the top of gastric folds to identify the gastro-esophageal junction (GEJ); only 51.4% used advanced endoscopy imaging routinely. Almost all respondents practiced endoscopic surveillance for non-dysplastic BE, but 43.7% performed eradication in selected cases and 30% practiced surveillance every 1-2 years. The majority of endoscopists managed low-grade dysplasia with surveillance (79.1%) and high-grade dysplasia with ablation (77.1%). Attending a training course on BE in the previous 5 years was significantly associated with the use of the Prague classification (OR 4.8, 95% CI 1.9-12.1), the top of gastric folds as landmark for the GEJ (OR 2.45, 95% CI 1.27-4.74) and advanced imaging endoscopic techniques (OR 3.33, 95% CI 1.53-7.29).
Conclusions: Practice patterns for management of BE among endoscopists are variable. Attending training courses on BE improves adherence to guidelines.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8379114 | PMC |
http://dx.doi.org/10.1007/s10620-020-06615-6 | DOI Listing |
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