《2014BSG Barrett食管诊断和治疗指南》内容预览：

ABSTRACT

These guidelines provide a practical and evidence-basedresource for the management of patients with Barrett'soesophagus and related early neoplasia. The Appraisalof Guidelines for Research and Evaluation （AGREE II）instrument was followed to provide a methodologicalstrategy for the guideline development. A systematicreview of the literature was performed for Englishlanguage articles published up until December 2012 inorder to address controversial issues in Barrett'soesophagus including de nition, screening anddiagnosis, surveillance, pathological grading fordysplasia, management of dysplasia, and early cancerincluding training requirements. The rigour and quality ofthe studies was evaluated using the SIGN checklistsystem. Recommendations on each topic were scored byeach author using a ve-tier system （A+, strongagreement, to D+, strongly disagree）。 Statements thatfailed to reach substantial agreement among authors,de ned as >80% agreement （A or A+）， were revisitedand modi ed until substantial agreement （>80%） wasreached. In formulating these guidelines, we took intoconsideration bene ts and risks for the population andnational health system, as well as patient perspectives.For the rst time, we have suggested strati cation ofpatients according to their estimated cancer risk basedon clinical and histopathological criteria. In order toimprove communication between clinicians, werecommend the use of minimum datasets for reportingendoscopic and pathological ndings. We advocateendoscopic therapy for high-grade dysplasia and earlycancer, which should be performed in high-volumecentres. We hope that these guidelines will standardiseand improve management for patients with Barrett'soesophagus and related neoplasia.

PURPOSE AND METHODS

The purpose of this guideline is to provide a prac-tical and evidence-based resource for the manage-ment of patients with Barrett's oesophagus andrelated early neoplasia. This document is thereforeaimed at gastroenterologists, physicians and nursepractitioners, as well as members of multidisciplin-ary teams （MDTs; surgeons, radiologists, patholo-gists）， who take decisions on the management ofsuch patients. The population covered by theseguidelines includes: patients with gastro-oesophageal re ux disease or other risk factors forBarrett's （obesity, family history for Barrett's andoesophageal adenocarcinoma （OAC））； every patientwith incident or prevalent Barrett's oesophagusregardless of their age, sex or comorbidities; patientswith early OAC and patients with intestinal metapla-sia （IM） at the gastro-oesophageal junction （GOJ）with no endoscopic evidence of Barrett'soesophagus. The previous British Society ofGastroenterology （BSG） guidelines were publishedin 2005 and since then there have been advances inthe diagnostic and management tools available.Within these guidelines, we have systematicallyreviewed the literature in order to address contro-versial issues in Barrett's oesophagus and to formu-late practical recommendations to guide patientmanagement. In particular, we have covered the fol-lowing key questions.

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