title: Surveillance of short-segment Barrett's esophagus using ultrathin transnasal endoscopy.
abstract: OBJECTIVE
  Newly developed ultrathin transnasal endoscope, the GIF-XP290N, makes possible a resolving power similar to the GIF-H260 at a distance of 3 mm. We conducted surveillance of subjects with Barrett's esophagus using this ultrathin transnasal endoscopy. In Japan the lower margin of the lower esophageal palisade vessels is defined the gastroesophageal junction in deep inspiration. We diagnose Barrett's esophagus if columnar epithelium is present on the oral side of the gastroesophageal junction.
  
  
  RESULTS
  Barrett's esophagus was confirmed in 116 out of 135 subjects (85.9%), with 17 cases of short-segment Barrett's esophagus (SSBE) and 99 of ultra-short-segment Barrett's esophagus. Close observation of the Barrett's esophagus mucosal structural pattern using narrow band imaging revealed 29 cases with an oval or round pattern, 29 with a long straight pattern, 47 with a villous pattern, 8 with a cerebriform pattern, and 6 with an irregular pattern according to Goda classification. Mucosal biopsies from all subjects with SSBE are examined. Histological examination revealed intestinal metaplasia in only eight subjects. We grouped the oval/round and long straight patterns as closed type, and the villous, cerebriform, and irregular patterns as open type. Analysis of the relationship between these mucosal patterns and background factors revealed a significant correlation between intestinal metaplasia and the open-type pattern.
  
  
  CONCLUSIONS
  We consider this new ultrathin transnasal endoscopy to be a useful technique for surveillance of Barrett's esophagus, especially SSBE.
authors.affiliation: Endoscopy Center, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Sugimoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawai
authors.forename: Sakiko
authors.initials: S
authors.lastname: Naito
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Yanagizawa
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yamagishi
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Fukuzawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Yagi
authors.forename: Jun
authors.initials: J
authors.lastname: Matsubayashi
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Nagao
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Tomiyama
authors.forename: Sumito
authors.initials: S
authors.lastname: Hoshino
authors.forename: Akihiko
authors.initials: A
authors.lastname: Tsuchida
authors.forename: Fuminori
authors.initials: F
authors.lastname: Moriyasu
mesh_terms: D000368:Aged; D001471:Barrett Esophagus / Q000175:diagnosis* / Q000473:pathology; D016099:Endoscopy, Gastrointestinal / Q000295:instrumentation* / Q000379:methods; D004947:Esophagus / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D011446:Prospective Studies
keywords: Barrett's esophagus; Narrow band imaging; close examination; mucosal structure; transnasal endoscopy