Researchers from Wisconsin, USA, assessed the feasibility of transnasal upper endoscopy for surveillance of patients with Barrett's esophagus.
They also evaluated its histopathologic yield for Barrett's metaplasia and dysplasia.
A total of 32 Barrett's patients were evaluated with both conventional upper endoscopy and transnasal upper endoscopy.
An effort was made to recruit patients known to have dysplasia.
Quadrantic biopsy specimens were taken with standard (conventional upper endoscopy) and pediatric (transnasal upper endoscopy) biopsy forceps at procedures performed at least 1 week apart.
Two blinded pathologists evaluated the specimens.
The team found that transnasal upper endoscopy detected Barrett's metaplasia histopathologically in 31 of 32 patients.
| Histopathologic yield for dysplasia is comparable with conventional upper endoscopy.|
Level of agreement for presence of dysplasia in biopsy specimens obtained between conventional upper endoscopy and transnasal upper endoscopy was excellent.
Interobserver agreement for dysplasia in specimens obtained by conventional upper endoscopy and by transnasal upper endoscopy was similar.
In addition, intraobserver agreement between conventional upper endoscopy and transnasal upper endoscopy biopsy specimens for dysplasia by the both pathologists was also similar.
No significant adverse effects were noted.
Dr Kia Saeian, of the Medical College of Wisconsin, Milwaukee, concluded on behalf of fellow colleagues, "Transnasal upper endoscopy is feasible and accurate for identification and histopathologic confirmation of Barrett's metaplasia.
"It also has a histopathologic yield for dysplasia comparable with conventional upper endoscopy."