Quality of Barrett's surveillance in The Netherlands: a standardized review of endoscopy and pathology reports.

Abstract:

OBJECTIVE:The quality of Barrett's surveillance relies on an adequate endoscopic inspection, obtaining a sufficient number of biopsy specimens, good communication of the endoscopic findings to the pathologist, and an accurate description of the histological findings by the pathologist. The aim of this study was to assess the quality of Barrett's surveillance in daily practice in The Netherlands. MATERIALS AND METHODS:A structured scoring list was developed to evaluate systematically the quality of endoscopy and pathology reports. From 15 hospitals, endoscopy reports and corresponding pathology reports were selected randomly and evaluated by two observers. In case of disagreement, the observers re-evaluated the reports in a consensus meeting. RESULTS:One hundred and fifty cases were evaluated. The adherence to current standard biopsy protocols (four quadrant biopsies every 2 cm) decreased with increasing Barrett's length: 0-5 cm: 79%; 5-10 cm: 50%; 10-15 cm: 30%. The indication for the endoscopy was mentioned in 28% of the pathology reports, in 4% the presence/absence of oesophagitis was communicated, and in 19% the location and/or aetiology of biopsies was described. The presence/absence of dysplasia was mentioned in 93% of pathology reports. CONCLUSION:Endoscopy reports and pathology reports in current practice do not include all relevant information for an adequate Barrett's surveillance. In short Barrett's oesophagus, the adherence to current standard biopsy protocols is acceptable, but in longer segments (with a higher risk for neoplastic progression) this is clearly insufficient. The communication between endoscopists and pathologist is suboptimal.

authors

Curvers WL,Peters FP,Elzer B,Schaap AJ,Baak LC,van Oijen A,Mallant-Hent RM,Ten Kate F,Krishnadath KK,Bergman JJ

doi

10.1097/MEG.0b013e3282f8295d

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

601-7

issue

7

eissn

0954-691X

issn

1473-5687

pii

00042737-200807000-00003

journal_volume

20

pub_type

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