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Hépato-Gastro. Volume 18, Number 2, 167-72, Mars-Avril 2011, Mini-revue

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Author(s) : Marine Camus, Romain Coriat, Frédéric Prat, Stanislas Chaussade

Summary : Screening for complications of neoplastic Barrett's oesophagus requires a tedious blind standardized protocol biopsies quadrant every 1 to 2 cm depending on the morphology of the Barrett's epithelium. To achieve that biopsies are targeted to areas suspicious of dysplasia, a method of high sensitivity is required. Chromoendoscopy has been developed in this direction. Acetic acid combined with high-resolution endoscopy and zooming represents an aid in the preparation of the oesophageal mucosa for visualization of suspicious anomalies. It is safe, cheap and easy to use. Acetic acid has proven its value in improving the visibility of the pit pattern. Several vital dyes have been tested, including methylene blue, indigo carmine and crystal violet, with mixed results. The FICE and NBI, immediate, reversible and attractive virtual chromoendoscopy techniques represent interesting tools for improving sensitivity in screening for Barrett's oesophagus and its complications. But these tools, which are capable of improvement so far, do not prove their use on a large population. For this, the systematic biopsy protocol Seattle remains the “gold standard” in monitoring the Barrett's oesophagus.

Keywords : chromoendoscopy, Barrett's esophagus, indigo carmin, crystal violet, acetic acid, NBI, FICE, DHG, dysplasie de haut grade, EBO, endobrachyœsophage, FICE, Fujinon Intelligent Color Enhancement, NBI, Narrow-Band Imaging