title: Comparative evaluation of esophageal Barrett's epithelium through esophageal capsule endoscopy and methylene blue chromoendoscopy.
abstract: BACKGROUND
  Patients presenting with Barrett's esophagus (BE) should be under life-long surveillance in an attempt to detect cancer in its early stages. Esophageal capsule endoscopy (ECE) is a new technique that enables a noninvasive evaluation of the esophagus.
  
  
  OBJECTIVE
  To evaluate ECE effectiveness compared with methylene blue (MB) chromoendoscopy for the detection of esophageal lesions in which there was suspicion of cancer, the length and pattern of BE, and the presence of hiatal hernia.
  
  
  METHODS
  Twenty-one patients with BE who underwent Nissen fundoplication and had a follow-up period of more than five years were prospectively enrolled in the study. The patients underwent ECE and chromoendoscopy with MB performed by different physicians who were blinded to each of the procedures.
  
  
  RESULTS
  ECE sensitivity, negative predictive value, and accuracy were 100%, 100%, and 79%, respectively, for the detection of esophageal lesions suspected of cancer. ECE accuracy in assessing BE length was 89% and in the evaluation of finger-like projections, circumferential BE, and mixed BE was 74%, 79%, and 74%, respectively. In relation to hiatal hernia detection, ECE sensitivity was 43% and its accuracy was 74%.
  
  
  CONCLUSIONS
  ECE appears to be a good method for detecting lesions in which there is suspicion of esophageal cancer and it had modest results in regard to the accurate identification of BE length and pattern. ECE is not a good method for detecting hiatal hernia. Further studies are needed in order to define the definitive role of ECE in BE monitoring.
authors.affiliation: Gastrointestinal Endoscopy Unit, University of São Paulo Medical School, São Paulo, Brazil. thiago.domingos@uniderp.edu.br
authors.forename: T A
authors.initials: TA
authors.lastname: Domingos
authors.forename: E G H
authors.initials: EG
authors.lastname: Moura
authors.forename: D C
authors.initials: DC
authors.lastname: Mendes
authors.forename: B C
authors.initials: BC
authors.lastname: Martins
authors.forename: R A A
authors.initials: RA
authors.lastname: Sallum
authors.forename: A
authors.initials: A
authors.lastname: Nasi
authors.forename: P
authors.initials: P
authors.lastname: Sakai
authors.forename: I
authors.initials: I
authors.lastname: Cecconello
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000473:pathology*; D053704:Capsule Endoscopy; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D006551:Hernia, Hiatal / Q000473:pathology; D006801:Humans; D008297:Male; D008751:Methylene Blue; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D008751:Methylene Blue