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RETROSPECTIVE COHORT STUDY OF CHRONOLOGICAL CHANGE OF SHORT‐SEGMENT BARRETT's ESOPHAGUS
Authors:Masako Asayama  Minoru Shibata  Yasuyuki Kondo  Masaru Tauchi  Tatsuro Yanagawa  Shinji Sato  Tomohiro Itoh  Tetsuo Isozaki  Kantaro Hisatomi  Nobuyuki Matsuhashi  Yukihiro Sakurai
Abstract:Background: The natural history of short‐segment Barrett's esophagus (SSBE) is not fully understood. We, thereby, conducted a retrospective cohort study to provide further information about chronological change of SSBE. Materials and methods: A total of 174 cases undergoing upper gastrointestinal endoscopy from April 1980 to October 2002 were diagnosed to have SSBE based on the definition of Barrett's esophagus proposed by the Japanese Society for Esophageal Diseases. A cohort of 100 patients with SSBE less than 3 cm was enrolled in the present study. The mean follow‐up period was 76.2 ± 59.9 months and 4.27 ± 2.66 endoscopic examinations were performed on each patient. The cumulative probability of elongation of SSBE to 3 cm or longer was estimated by the Kaplan‐Meier method. Then, independent contributing factors to its elongation were determined using Cox's proportional hazard model. Results: Elongation of SSBE to 3 cm or longer occurred in 30 patients (30%) during the follow‐up period. The cumulative 5‐year probability of elongation of SSBE to 3 cm or longer was 18.4%. Hiatal hernia, severe reflux esophagitis and SSBE 1 cm or longer at initial diagnosis were proven to be independent contributing factors to its elongation. Conclusions: The present study demonstrated that SSBE has a tendency to increase its length over time especially when it is accompanied by hiatal hernia or by severe reflux esophagitis.
Keywords:chronological change  hiatal hernia  reflux esophagitis  short‐segment Barrett's esophagus
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