Endoscopy 2022; 54(S 01): S41
DOI: 10.1055/s-0042-1744643
Abstracts | ESGE Days 2022
ESGE Days 2022 Oral presentations
16:30–17:30 Thursday, 28 April 2022 Club A. EARLY ESOPHAGEAL CANCER: Taking the diagnostics to a next level

POOLING BARRETT’S ESOPHAGUS (BE) SURVEILLANCE ENDOSCOPIES ON DEDICATED BE ENDOSCOPY LISTS IMPROVES ADHERENCE TO THE FOUR-QUADRANT RANDOM (4QR) BIOPSY PROTOCOL

I. Beaufort
1   St. Antonius Ziekenhuis, Nieuwegein, Netherlands
2   Universitair Medisch Centrum Utrecht, Utrecht, Netherlands
,
J. Meeuse
3   Ziekenhuis Rivierenland Tiel, Tiel, Netherlands
,
P. van de Meeberg
4   Slingeland Ziekenhuis, Doetinchem, Netherlands
,
Y. Alderlieste
5   Beatrixziekenhuis, Gorinchem, Netherlands
,
R. Verbeek
6   Groene Hart Ziekenhuis, Gouda, Netherlands
,
M. Sikkema
7   Elisabeth-TweeSteden Ziekenhuis, Tilburg, Netherlands
,
B. Scheffer
8   Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, Netherlands
,
T. Naber
9   Tergooi, Hilversum, Netherlands
,
M. Ledeboer
10   Deventer Ziekenhuis, Deventer, Netherlands
,
P. Pullens
11   Meander Medisch Centrum, Amersfoort, Netherlands
,
W. van de Vrie
12   Albert Schweitzer Ziekenhuis, Dordrecht, Netherlands
,
M. Willems
13   Ziekenhuis Sint Jansdal, Harderwijk, Netherlands
,
R. Lieverse
14   Ziekenhuisgroep Twente, Almelo, Netherlands
,
M. Verhagen
15   Diakonessenhuis, Utrecht, Netherlands
,
J. Baars
16   Amphia Ziekenhuis, Breda, Netherlands
,
N. van Heel
17   Gelre Ziekenhuizen, Apeldoorn, Netherlands
,
P. Bos
18   Ziekenhuis Gelderse Vallei, Ede, Netherlands
,
J. Burger
19   Rijnstate, Arnhem, Netherlands
,
B. Weusten
1   St. Antonius Ziekenhuis, Nieuwegein, Netherlands
2   Universitair Medisch Centrum Utrecht, Utrecht, Netherlands
› Author Affiliations
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Aims For BE patients, guidelines recommend endoscopic surveillance with 4QR biopsies every 2 centimeters of BE length. In clinical practice however, adherence to the 4QR biopsy protocol is low. We wished to investigate whether pooling BE surveillance endoscopies on dedicated endoscopy lists performed by dedicated endoscopists enhances biopsy protocol adherence and subsequently dysplasia detection rates (DDR).

Methods Data were used from the ACID-study (Netherlands Trial Registry NL8214), a prospective trial on BE surveillance in 18 community hospitals in the Netherlands (data entry since October 2019). BE patients with a history of dysplasia were excluded. Biopsy protocol adherence was defined as 4QR biopsies every 2 centimeters of circumferential BE extent, plus at least 1 biopsy every 2 centimeters of BE tongues. Biopsy protocol adherence and DDR were compared for patients on dedicated and non-dedicated lists.

Results BE surveillance was performed on dedicated endoscopy lists in 3/18 hospitals. 854 patients were included, 204 on dedicated lists and 650 on general endoscopy lists. Mean age (65.2 vs 64.8), male sex (73% vs 69%) and median BE length (C1M4 vs C1M3) were comparable between the two groups. Sedation was more often administered during dedicated list endoscopies (p<0.0001). 4QR biopsy protocol adherence was significantly better for endoscopies on dedicated lists compared to non-dedicated lists (83% vs 63%, p<0.0001). DDR were not significantly different (8.4% and 7.1% respectively, p=0.66).

Table 1

Dedicated BE list (N=204)

Non-dedicated BE list (N=650)

p-value

Barrett length, median (IQR)

Prague C

1 (0-4)

1 (0-4)

0.48

Prague M

4 (2-5)

3 (2-5)

0.11

Sedation used, n (%)

166 (82)

404 (62)

<0.0001

Adherence 4QR biopsy protocol, n (%)

168 (83)

409 (63)

<0.0001

Dysplasia, n (%)

17 (8.4)

46 (7.1)

0.66

Conclusions Pooling BE surveillance endoscopies on dedicated lists is associated with better 4QR biopsy protocol adherence. This however did not translate into a higher DDR.



Publication History

Article published online:
14 April 2022

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