BACKGROUND

Current guidelines recommend that endoscopic surveillance of Barrett's esophagus (BE) be performed by using a strict biopsy protocol. However, novel methods to improve BE surveillance are still needed.

OBJECTIVE

To evaluate the impact of Barrett's inspection time (BIT) on yield of surveillance.

DESIGN

Post hoc analysis of data obtained from a clinical trial.

SETTING

Five tertiary referral centers.

PATIENTS

Patients undergoing BE surveillance.

INTERVENTIONS

Coordinators prospectively recorded the time spent inspecting the BE mucosa with a stopwatch.

MAIN OUTCOME MEASUREMENTS

Endoscopically suspicious lesions, high-grade dysplasia (HGD)/esophageal adenocarcinoma (EAC).

RESULTS

A total of 112 patients underwent endoscopic surveillance by 11 individual endoscopists. Patients with longer BITs were more likely to have an endoscopically suspicious lesion (P < .001) and more endoscopically suspicious lesions (P = .0001) and receive a diagnosis of HGD/EAC (P = .001). There was a direct correlation between the endoscopist's mean BIT per centimeter of BE and the detection of patients with HGD/EAC (ρ = .63, P = .03). Endoscopists who had an average BIT longer than 1 minute per centimeter of BE detected more patients with endoscopically suspicious lesions (54.2% vs 13.3%, P = .04), and there was a trend toward a higher detection rate of HGD/EAC (40.2% vs 6.7%, P = .06).

LIMITATIONS

Post hoc analysis of an enriched study population and experienced endoscopists at tertiary referral centers.

CONCLUSIONS

Longer time spent inspecting the BE segment is associated with the increased detection of HGD/EAC. Taking additional time to perform a thorough examination of the BE mucosa may serve as an easy and widely available method to improve the yield of BE surveillance.