Scandinavian journal of gastroenterology. Supplement最新文献

{"title":"Long-term risk of oesophagitis, Barrett's oesophagus and oesophageal cancer in achalasia patients.","authors":"Ivonne Leeuwenburgh,&nbsp;Jelle Haringsma,&nbsp;Herman Van Dekken,&nbsp;Pieter Scholten,&nbsp;Peter D Siersema,&nbsp;Ernst J Kuipers","doi":"10.1080/00365520600664201","DOIUrl":"https://doi.org/10.1080/00365520600664201","url":null,"abstract":"<p><p>Achalasia is a motility disorder of the oesophagus of unknown origin in which loss of relaxation of the lower oesophageal sphincter (LOS) and aperistalsis in the distal oesophagus leads to functional oesophageal obstruction. The treatment is symptomatic, aimed at lowering of the LOS pressure, and may be accompanied by various side effects, including gastro-oesophageal reflux, a risk factor for oesophagitis and its complications. Stasis and fermentation can also lead to inflammation of the oesophageal mucosa, giving rise to hyperplasia of the epithelium, multifocal dysplasia and in some patients eventually squamous cell carcinoma. Unfortunately, the sensitivity and specificity of endoscopical inspection to assess inflammation or dysplasia of the oesophageal lining is low, such that biopsy sampling is necessary for accurate assessment. Although it is generally accepted that achalasia is a pre-malignant disorder, the reported increased risk of patients with achalasia developing a squamous cell carcinoma varies from 0 to 140 times that of the normal population. In addition, achalasia may predispose to Barrett's metaplasia and oesophageal adenocarcinoma, which have been described in case reports after myotomy. Surveillance endoscopy with tissue sampling to detect pre-neoplastic lesions has been recommended, even though this can be very difficult due to mucosal adherence of food as well as hyperplastic changes of the mucosa. In the event of moderate to severe inflammation and/or persisting stasis of food despite adequate LOS pressure-lowering therapy, the surveillance interval should be shortened and performed after a 3-day liquid diet. The exact technique and time intervals still need to be established, however.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 243","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365520600664201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26095420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive measurement of liver fibrosis: application of the FibroScan in hepatology.","authors":"Claudia Verveer,&nbsp;Robert J de Knegt","doi":"10.1080/00365520600664359","DOIUrl":"https://doi.org/10.1080/00365520600664359","url":null,"abstract":"<p><p>The liver biopsy is still regarded as the gold standard for the assessment of liver disease. However, there is a growing demand for non-invasive assessment of liver fibrosis, which is the most important prognostic factor in chronic liver disease, in particular in viral hepatitis. Transient elastography is a novel, non-invasive and rapid bedside method for assessing liver fibrosis by measuring liver stiffness. Some recent extensive studies, mainly from France, have demonstrated that measurement with the FibroScan is a good alternative for the liver biopsy. The amount of fibrosis can be quantified very easily and reliably. In this review, we describe the technique and discuss the available studies in order to establish applicability and to provide points for discussion.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 243","pages":"85-8"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365520600664359","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26096418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bile acids and Barrett's oesophagus: a sine qua non or coincidence?","authors":"Rudy R Sital,&nbsp;Johannes G Kusters,&nbsp;Felix W M De Rooij,&nbsp;Ernst J Kuipers,&nbsp;Peter D Siersema","doi":"10.1080/00365520600664219","DOIUrl":"https://doi.org/10.1080/00365520600664219","url":null,"abstract":"<p><strong>Background: </strong>Barrett's oesophagus (BO), a premalignant condition associated with the development of oesophageal adenocarcinoma (OAC), is thought to be a consequence of chronic duodeno-gastro-oesophageal reflux. Of the refluxates, bile acids, either alone or in combination with acid, are probably the most important.</p><p><strong>Methods: </strong>Analysis of the literature on the role played by bile acids in inducing BO and/or progression to OAC.</p><p><strong>Results: </strong>Combined pH and Bilitec 2000 (as a measure of bile reflux) monitoring and oesophageal aspiration studies in humans suggest a combined role for bile acids, particularly taurine conjugated bile acids, in causing oesophageal mucosal injury. Evidence from animal models has demonstrated that duodenal juice alone is also able to induce BO and/or OAC. Likewise, ex vivo studies with biopsies from BO patients show that increased proliferation and cyclo-oxygenase-2 expression are present after a pulsed exposure to acid or conjugated bile acids, but not if acid and bile acids are combined. Proton-pump inhibitors (PPIs) have been shown to decrease the biliary component of the refluxate. There is some evidence that PPIs are able to reduce neoplastic progression in BO. On the other hand, chronic PPIs can also stimulate bacterial overgrowth, which can result in increased production of secondary bile acids, particularly deoxycholic acid, in the stomach. Deoxycholic acid has been demonstrated to have a tumour-promoting capacity.</p><p><strong>Conclusions: </strong>It is unknown what factors of the refluxate (acid and/or bile) induce BO and/or promote carcinogenesis, but there is evidence that secondary bile acids play a role. A better understanding of the molecular steps involved in the induction of BO, and the role of bile acids herein, may identify targets at which preventive therapies can be directed.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 243","pages":"11-7"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365520600664219","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26095421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease outcome of inflammatory bowel disease patients: general outline of a Europe-wide population-based 10-year clinical follow-up study.","authors":"Frank L Wolters,&nbsp;Maurice G Russel,&nbsp;Jildou Sijbrandij,&nbsp;Leo J Schouten,&nbsp;Selwyn Odes,&nbsp;Lene Riis,&nbsp;Pia Munkholm,&nbsp;Ebbe Langholz,&nbsp;Paolo Bodini,&nbsp;Colm O'Morain,&nbsp;Kostas Katsanos,&nbsp;Epameinondas Tsianos,&nbsp;Severine Vermeire,&nbsp;Gilbert Van Zeijl,&nbsp;Charles Limonard,&nbsp;Ole Hoie,&nbsp;Morten Vatn,&nbsp;Bjørn Moum,&nbsp;Reinhold W Stockbrügger","doi":"10.1080/00365520600664250","DOIUrl":"https://doi.org/10.1080/00365520600664250","url":null,"abstract":"<p><strong>Objective: </strong>To give a general outline of a 10-year clinical follow-up study of a population-based European cohort of inflammatory bowel disease (IBD) patients and to present the first results in terms of clinical outcome parameters and risk factors.</p><p><strong>Materials and methods: </strong>A population-based cohort of newly, prospectively, diagnosed cases was initiated between 1991 and 1993. The 2201 patients with IBD (706 had Crohn's disease (CD), 1379 had ulcerative colitis (UC) and 116 had indeterminate colitis) originated from 20 different areas in 11 different European countries and Israel. For the 10-year follow-up of this cohort, electronic data-collecting instruments were made available through an Internet-based website. Data concerning vital status, disease activity, medication use, surgical events, cancer, pregnancy, fertility, quality of life and health-care costs were gathered. A blood sample was obtained from patients and controls to perform genotypic characterization.</p><p><strong>Results: </strong>Thirteen centres from eight European countries and Israel participated. In 958 (316 CD and 642 UC) out of a total of 1505 IBD patients (64%) from these 13 centres, a complete dataset was obtained at follow-up. Even though an increased mortality risk was observed in CD patients 10 years after diagnosis, a benign disease course was observed in this patient group in terms of disease recurrence. A correlation between ASCA and CARD15 variants in CD patients and complicated disease course was observed. A north-south gradient was observed regarding colectomy rates in UC patients. Direct costs were found to be highest in the first year after diagnosis and greater in CD patients than in UC patients, with marked differences between participating countries.</p><p><strong>Conclusions: </strong>This 10-year clinical follow-up study of a population-based European cohort of IBD patients provides updated information on disease outcome of these patient groups.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 243","pages":"46-54"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365520600664250","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26095426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ascites and spontaneous bacterial peritonitis in patients with liver cirrhosis.","authors":"Karel J van Erpecum","doi":"10.1080/00365520600664342","DOIUrl":"https://doi.org/10.1080/00365520600664342","url":null,"abstract":"<p><p>Liver cirrhosis is a frequent phenomenon in chronic liver diseases such as hepatitis B, hepatitis C, alcohol-related liver damage, autoimmune hepatitis and hemochromatosis. Ascites is the most frequent complication of cirrhosis. We discuss pathogenesis, diagnosis and state-of-the-art clinical management of ascites with emphasis on recent promising developments, such as covered transjugular intrahepatic portosystemic shunt (TIPS). Spontaneous bacterial peritonitis occurs in up to 10% of patients with ascites because of bacterial overgrowth with translocation through the increased permeable small intestinal wall and impaired defence mechanisms. The addition of albumin to standard antibiotic therapy may decrease mortality of spontaneous bacterial peritonitis by decreasing the incidence of renal insufficiency. Patients with coexistent marked hyperbilirubinaemia or pre-existent renal impairment could benefit from adjuvant albumin. Probiotics (bacterial food supplements) have been claimed to improve the state of underlying liver disease and may be useful in the primary and secondary prevention of spontaneous bacterial peritonitis.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 243","pages":"79-84"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365520600664342","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26096417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and treatment of benign focal liver lesions.","authors":"Türkan Terkivatan,&nbsp;Shahid M Hussain,&nbsp;Rob A De Man,&nbsp;Jan N M Ijzermans","doi":"10.1080/00365520600664391","DOIUrl":"https://doi.org/10.1080/00365520600664391","url":null,"abstract":"<p><strong>Background: </strong>With the routine use of improved imaging modalities, more benign liver lesions are detected nowadays. An accurate characterization of these incidental lesions may be a challenge, and frequently a biopsy or even unnecessary surgery is being performed. However, these interventions are not always to the benefit of the patient.</p><p><strong>Methods: </strong>A Medline search of studies relevant to imaging diagnosis and management of the most common, benign, solid and non-solid liver lesions was undertaken. References from identified articles were handsearched for further relevant articles. The authors' own experiences with benign liver lesions were also taken into account.</p><p><strong>Results: </strong>Although atypical imaging features are the exception rather than the rule, it is sometimes difficult to differentiate between benign and malignant lesions, and knowledge of their imaging features is essential if unnecessary work-up is to be avoided. The use of tissue-specific contrast media, which has clearly improved the accuracy of highly advanced radiological techniques, may be helpful during differential diagnosis. Once having established an accurate diagnosis, surgery is rarely indicated for a benign liver lesion because of its asymptomatic nature.</p><p><strong>Conclusion: </strong>Knowledge of imaging features and a clear management strategy during diagnostic work-up, emphasizing the indications for surgery, will minimize the number of patients who have to undergo biopsy or unnecessary surgery.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 243","pages":"102-15"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365520600664391","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26096420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive oesophageal resection for distal oesophageal cancer: a review of the literature.","authors":"Joris J G Scheepers,&nbsp;Chris J J Mulder,&nbsp;Donald L Van Der Peet,&nbsp;Sijbren Meijer,&nbsp;Miguel A Cuesta","doi":"10.1080/00365520600664425","DOIUrl":"https://doi.org/10.1080/00365520600664425","url":null,"abstract":"<p><p>Oesophagus resection is adequate treatment for some benign oesophageal diseases, especially caustic and peptic stenosis and end-stage motility dysfunction. However, the most frequent indications for oesophageal resection are the high-grade dysplasia of Barrett oesophagus and non-metastasized oesophageal cancer. Different procedures have been developed for performing oesophageal resection given the 5-year survival rate of only 18% among patients operated on. A disadvantage of the conventional approach is the high morbidity rate, especially with pulmonary complications. Minimally invasive oesophageal resections, which were first performed in 1991, may reduce this important morbidity and preserve the oncologic outcome. The first reports of morbidity and respiratory complications with this approach were disappointing and it seemed likely that the procedure would have to be abandoned. However, in the past 5 years, Japanese groups and the group of Luketich in Pittsburgh have given these techniques an important impetus. The outcomes of the new series are different from those in the beginning period, and are leading to an enormous expansion worldwide. Important factors behind the change are standardization of the operative technique, the experience of many surgeons with more advanced laparoscopic procedures, important improvements in instruments for dissection and division of tissues, a better technique in use of anaesthesia, and a better selection of patients for operation. Two minimally invasive techniques are being perfected: the three-stage operation by right thoracoscopy and laparoscopy, and the transhiatal laparoscopic approach. The former may be applied successfully for any tumour in the oesophagus, whereas the latter seems ideal for distal oesophageal and oesophagogastric junction tumours. This review article discusses all these aspects, giving special attention to indications and operative technique.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 243","pages":"123-34"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365520600664425","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26096422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sentinel node staging in colon carcinoma: value of sentinel lymph node biopsy with radiocolloid and blue staining.","authors":"S E J Terwisscha Van Scheltinga,&nbsp;F C Den Boer,&nbsp;R Pijpers,&nbsp;G A Meyer,&nbsp;A F Engel,&nbsp;R Silvis,&nbsp;S Meijer,&nbsp;J R M van der Sijp","doi":"10.1080/00365520600664524","DOIUrl":"https://doi.org/10.1080/00365520600664524","url":null,"abstract":"<p><strong>Background: </strong>Nodal staging accuracy is important in the prognosis and selection of patients for chemotherapy. This prospective study aims to assess the feasibility and accuracy of the sentinel lymph node procedure (SNP) using radiocolloid and blue dye in colon carcinoma.</p><p><strong>Methods: </strong>In 56 patients, lymphatic mapping was accomplished by means of intraoperatively injecting patent blue and nanocoll subserosally around the tumour. Sentinel nodes (SNs) were harvested ex-vivo. Nodes were stained with H&E. If lymph nodes were interpreted as negative for metastatic tumour, serial sectioning and immunohistochemical staining were performed.</p><p><strong>Results: </strong>At least one SN was detected in 49 of 53 patients (92.5%). Three patients were excluded because of preoperatively detected metastases. Overall, 121 SN were harvested with a mean of 2.2 SN/patients. Eighteen patients had tumour positive nodes. In four patients, pathological nodes were palpable during operation and were excluded. The SN was histologically negative in 2 of 14 patients with positive nodes (false-negative rate 14.3%). In 5 of 14 patients with positive nodes, the SN was the exclusive site of regional nodal metastasis. Four patients were upstaged by immunohistochemical staining (28.6%). The negative predictive value was 93.9% and the overall accuracy 95.6%. Scintigraphy was done in 17 patients. In three patients the SN was detected only by this modality.</p><p><strong>Discussion: </strong>The SN biopsy with the combined technique proved a feasible technique with a steep learning curve. It can change the initial staging from stage II to stage III colon carcinoma. Scintigraphy can improve the success rate of the technique.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 243","pages":"153-7"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365520600664524","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26094142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemoprevention for colon cancer: new opportunities, fact or fiction?","authors":"J S Terhaar Sive Droste,&nbsp;J B Tuynman,&nbsp;H M Van Dullemen,&nbsp;C J J Mulder","doi":"10.1080/00365520600664284","DOIUrl":"https://doi.org/10.1080/00365520600664284","url":null,"abstract":"<p><p>Colorectal cancer (CRC) is still a disease with a high incidence and mortality. Prevention of (pre-) cancerous lesions of CRC by endoscopic screening is promising, but costs are high and identification of high-risk populations is difficult. Since screening both average-risk and high-risk populations for CRC has its logistic and financial limitations, new primary prevention strategies are sought. Substantial evidence has shown that non-steroidal anti-inflammatory drugs (NSAIDs) and selective COX-2 inhibitors can reduce the incidence and mortality of CRC. However, long-term use of NSAIDs is associated with substantial gastrointestinal toxicity and may cause an exacerbation in IBD patients. Selective COX-2 inhibitors, with a better toxicity profile and no flare-up in IBD disease activity, are therefore attractive candidates for prevention. Chemoprevention with low-dose aspirin can be considered for individuals carrying a high risk for CRC. Folate supplementation is beneficial to the folate-depleted patients, since significant risk reductions for CRC are reported. Moreover, it might be applicable to the general population because it is safe, inexpensive and protects against vascular diseases. In line with drugs beneficial for multiple disease entities, statins have recently been proposed to reduce CRC risk. Ursodeoxycholic acid has been shown to decrease the incidence of colonic dysplasia in patients with ulcerative colitis and PSC and possibly reduces recurrence rates of polyps in general. Unfortunately, prospective randomized trials, in both high-risk and general population, are not available and the evidence is still controversial. Furthermore, cumulative epidemiological and observational data suggest the potential role of hormones as a chemoprotective agent. An increase in CRC in females with an early menopause, as well as a decrease of CRC in women with hormone replacement therapy justify further research into this issue. In IBD patients, both the severity and duration of the inflammation are the most evident risk factors for the development of dysplasia and subsequently cancer. Remission of inflammation, clinically, endoscopically and histologically, in IBD is the major goal. Long-term use of 5-aminosalicylates (5-ASA) has been shown to decrease the incidence of CRC and may hold the best promise as a chemoprotective agent in IBD. In parallel with primary prevention strategies in vascular medicine, the aim might be to postpone adenoma formation, for instance for 10 years, thereby achieving a significant risk reduction for CRC. In current practice, folate supplementation along with low-dose aspirin use in high-risk patients may be most attractive candidates, while future studies will have to clarify the role of these and other chemoprotective agents.</p>","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 243","pages":"158-64"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365520600664284","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26094143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New developments in the endoscopic detection and treatment of early neoplasia in Barrett's oesophagus.","authors":"Jacques J G H M Bergman","doi":"10.1080/00365520600664227","DOIUrl":"https://doi.org/10.1080/00365520600664227","url":null,"abstract":"During recent decades, the incidence of oesophageal adenocarcinoma has increased by almost 400%, and is now the cancer with the fastest rising incidence in the Western world [1]. Most oesophageal adenocarcinomas are believed to develop from a precursor lesion, the so-called Barrett’s oesophagus [2]. Barrett’s oesophagus is a condition in which the normal squamous lining of the distal oesophagus has been replaced by columnar epithelium with intestinal metaplasia. Malignant degeneration of Barrett’s oesophagus is thought to be a multi-step process in which intestinal metaplasia progresses through lowgrade dysplasia and high-grade dysplasia into intramucosal and invasive carcinoma [3]. Endoscopic surveillance, aimed at identifying patients with early and curable malignancy, is currently considered the monitoring technique of choice in patients with Barrett’s oesophagus [4]. In this article, I discuss the endoscopic detection and treatment of early neoplasia in these patients.","PeriodicalId":21517,"journal":{"name":"Scandinavian journal of gastroenterology. Supplement","volume":" 243","pages":"18-24"},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/00365520600664227","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26095422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}