最新2008年Barrett食管诊断监视和治疗PREAMBLEThe.DOCVIP

最新2008年Barrett食管诊断、监视和治疗指南 PREAMBLE The guidelines for the diagnosis, surveillance and therapy of Barrett’s esophagus were originally published by the American College of Gastroenterology in 1998 and updated in 2002. These and other guidelines undergo periodic review.Significant advances have occurred in the area of Barrett’s esophagus over the past four years leading to another revision of the prior guidelines. These advances include the potential use of esophageal capsule endoscopy for the diagnosis and screening of Barrett’s esophagus, data regarding the outcome of low-grade dysplasia, the treatment of high-grade dysplasia using photodynamic therapy, and the development of new ablation techniques such as radiofrequency ablation. These guidelines are intended to be applied by physicians who see Barrett’s esophagus patients and are intended to indicate a preferred, but certainly not the only, acceptable approach.Physicians need to choose the course best suited to the individual patient and to the variables that exist at the time of decision making. The guidelines are for adult patients with the diagnosis of Barrett’s esophagus, as defined herein. 前言 美国胃肠病学会于1998年原版发布了Barrett食管的诊断、监视和治疗指南，并于2002年进行了修订。这些指南已经经历了一定时间的检验。在过去的四年中，在Barrett食管领域已经产生了一些有意义的进展，这引导我们对前一版本的指南进行新一轮的修订。这些进展包括：胶囊内镜在Barrett食管诊断和筛查中的应用、关于轻度不典型增生临床结局的资料、光动力学疗法治疗重度不典型增生以及新型消融技术辟如射频消融的发展。这一指南主要服务于诊治Barrett食管病人的内科医生，并仅作为临床的优先参考，但并不是唯一的参考。内科医生在做出临床决定时需要选择最适合于每个病人及其不同病情的治疗路线。本指南是针对被诊断为Barrett食管的成人患者的。 Both these and the original guidelines were developed under auspices of the American College of Gastroenterology and the Practice Parameters Committee and approved by the Board of Trustees. The world literature was reviewed extensively for the original guidelines and once again reviewed using the National Library of Medicine database. Search terms used included Barrett’s esophagus, esophageal neoplasm, esophagus, intestinal metaplasia, esophageal diseases, and adenocarcinoma, all appropriate studies and an