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Does magnifying endoscopy improve the diagnosis of erosive esophagitis?

Abstract：

BACKGROUND AND AIMS:Low-grade erosive esophagitis (i.e. Los Angeles grade A) is the most predominant type of esophagitis in Japan. It is unclear whether all the mucosal breaks detected by conventional endoscopy are indicative of esophageal mucosal erosion. Hospital-based, cross-sectional, cross-over, observational study was assigned to investigate the value of magnifying endoscopy for diagnosis of erosive esophagitis. METHODS:From August to December 2006, 178 consecutive patients with upper gastrointestinal symptoms were enrolled at three university hospitals and one national medical center in western Japan. Before endoscopy, all participants were requested to answer questionnaires concerning their symptoms. Experienced endoscopists performed an endoscopic diagnosis of each patient first with a conventional standard view and then with a magnifying view. Endoscopic diagnostic concordance between conventional and magnifying endoscopic view for erosive esophagitis was calculated. Relationship between a variety of symptoms and erosive esophagitis was also evaluated. RESULTS:Erosive esophagitis was identified using conventional and magnifying endoscopy in 14.6% and 17.4% of patients, respectively. Eleven false-negative and six false-positive diagnoses using conventional endoscopy occurred among the 178 enrolled patients. The weighted kappa value of diagnostic concordance for erosive esophagitis between the two endoscopic views was 0.76. The prevalence of erosive esophagitis in patients with reflux-, dysmotility-, and ulcer-like symptoms was 20.7%, 24.1%, and 15.2%, respectively. CONCLUSIONS:Magnifying endoscopy did not significantly improve the diagnostic sensitivity of erosive esophagitis over non-magnifying, conventional endoscopy. Erosive esophagitis was frequently identified in patients that did not have reflux symptoms.

journal_name

J Gastroenterol Hepatol

journal_title

Journal of gastroenterology and hepatology

authors

Amano Y,Yamashita H,Koshino K,Ohshima T,Miwa H,Iwakiri R,Fujimoto K,Manabe N,Haruma K,Kinoshita Y

doi

10.1111/j.1440-1746.2008.05453.x

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

1063-8

issue

7 Pt 1

eissn

0815-9319

issn

1440-1746

pii

JGH5453

journal_volume

pub_type

杂志文章,多中心研究

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Does magnifying endoscopy improve the diagnosis of erosive esophagitis?