Huidig beleid bij de surveillance van de barrettslokdarm in Nederland

To gain more insight into current surveillance and treatment of patients with Barrett’s oesophagus with the aim of developing new guidelines.

Design

Questionnaire.

Method

In 2004, a questionnaire was sent to 337 physician-endoscopists who were all registered with the Netherlands Society of Gastroenterology. The questionnaire inventoried various aspects of surveillance and treatment of patients with Barrett’s oesophagus.

Results

Of the 289 respondents (86), 96 carried out surveillance or had it carried out, on at least a proportion of their patients with Barrett’s oesophagus. A total of 258 respondents (89) carried out the surveillance themselves. An endoscopic indication of the presence of Barrett’s oesophagus was, for 31 of the respondents, enough reason to carry out surveillance of this condition irrespective of the results of pathological investigations. 75 applied an age limit for surveillance for Barrett’s. The median age limit is 75 years (interquartile distance: 70-75) and 46 of the treating professionals limited themselves to patients who, on the basis of age and co-morbidity, may undergo oesophageal resection. The choice of treatment in early neoplasia, surgical or endoscopic, depends not only on the histological diagnosis, but also on the age and the co-morbidities of the patient.

Conclusion

Surveillance of Barrett’s oesophagus is widespread in the Netherlands, and in general is carried out in accordance with international guidelines. The possibilities of treating patients with high-grade dysplasia or intramucosal carcinoma of the oesophagus endoscopically, and of consulting external advisory bodies are still insufficiently utilized.

Ned Tijdschr Geneeskd. 2007;151:1879-84