Bergman J J, Marsman W A, Krishnadath K K, Fockens P, van Lanschot J J, Tytgat G N
Afd. Maag-, Darm- en Leverziekten, Academisch Medisch Centrum, Meibergdreef 9, 1105 AZ Amsterdam.
Ned Tijdschr Geneeskd. 2003 Nov 15;147(46):2275-81.
In a Barrett's oesophagus without dysplasia, endoscopic control every 3-5 years is sufficient. If low-grade dysplasia is encountered in the surveillance biopsies, then endoscopy should be repeated within 3-6 months and yearly thereafter if the low-grade dysplasia persists. Antacid medication must be prescribed in cases with extensive inflammation. The endoscopic treatment of patients with high-grade dysplasia and/or early cancer of the mucosa in a Barrett's oesophagus (tissue ablation and/or mucosa resection) seems a promising alternative to surgery in view of the combination of effectiveness, limited invasiveness compared to surgical resection, and the preservation of a functional oesophagus. Data from long-term follow-up are still limited. Strict endoscopic surveillance will probably detect metachronic abnormalities in an early and still curable stage, creating a new opportunity for endoscopic treatment.
对于无发育异常的巴雷特食管，每3至5年进行一次内镜检查即可。如果在监测活检中发现低度发育异常，则应在3至6个月内重复进行内镜检查，若低度发育异常持续存在，则此后每年进行一次。对于有广泛炎症的病例，必须开具抗酸药物。鉴于其有效性、与手术切除相比侵袭性有限以及能保留功能性食管等因素，对巴雷特食管中高级别发育异常和/或黏膜早期癌患者进行内镜治疗（组织消融和/或黏膜切除）似乎是一种有前景的手术替代方法。长期随访数据仍然有限。严格的内镜监测可能会在早期且仍可治愈阶段检测到异时性异常，从而为内镜治疗创造新机会。
