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.
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.
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.
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.
aAmsterdam Gastroenterological Association
Departments of bGastroenterology and Hepatology
cPathology, Academic Medical Centre
dDepartment of Gastroenterology and Hepatology, Onze Lieve Vrouwe Gasthuis, Amsterdam
eDepartment of Gastroenterology and Hepatology, Medical Centre Alkmaar, Alkmaar
fDepartment of Internal Medicine, Flevo Hospital, Almere, The Netherlands
Correspondence to Jacques J.G.H.M. Bergman, Department of Gastroenterology and Hepatology, Academic Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
Tel: +31 20 5663556; e-mail: email@example.com
Data presented previously at DDW 2007 in Washington and published as an abstract in Gastroenterology 2007; 132 (Suppl 2):A640.
Received 13 November 2007 Accepted 13 January 2008