LINEE GUIDA PER LA SORVEGLIANZA DI PAZIENTI CON ESOFAGO DI BARRETT

There is well recognized risk of developing adenocarcinoma in patients with Barrett's esophagus. Aim of the present paper is to suggest guidelines for patients with this condition, according to the personal experience of the authors and to recent literature. Although the long-term benefits of endoscopic surveillance have been determined, there is consensus that all patients with histologic confirmation of Barrett's esophagus might benefit from periodic examination with multiple biopsies of the columnar portion of the epithelium. Follow-up programs should be different on the basis of histological criteria: patients with specialized columnar epithelium and/or presence of dysplasia in the bioptic samples might he endoscoped more frequently (every 12 months) than patients with fundal or gastric columnar epithelium and absence of dysplasia (every 24 months). High grade dysplasia indicates the need of surgical intervation in feasible patients. Patients with Barrett's esophagus should be referred to specialized centers, both for high quality patient care and for research purposes.