Original articleClinical endoscopyDiagnostic yield of methylene blue chromoendoscopy for detecting specialized intestinal metaplasia and dysplasia in Barrett's esophagus: a meta-analysis
Section snippets
Materials and methods
By using the MEDLINE, EMBASE, and Cochrane Central Trials databases from January 1980 through October 2007, a thorough literature search for prospective trials that compared MB chromoendoscopy with standard RB for detection of SIM and dysplasia in patients with BE was conducted, along with an additional search of PubMed and a manual search of cited references in selected articles. We used the following text words as search terms: Barrett's esophagus, Barrett's oesophagus, methylene blue
Results
Seventy-four articles were initially identified by using the search strategy described (Fig. 1). Fifty-one articles (clinical reviews [n = 39], editorials [n = 8], and brief communications or letters to the editors [n = 4]) were excluded after preliminary review, which left 23 articles for detailed evaluation. Of these, 8 published articles that met the inclusion criteria were identified.10, 11, 12, 13, 14, 15, 16, 17 One additional abstract was identified by hand search.18 In total, 9 studies
Discussion
Our meta-analysis found no significant difference in yield of MB chromoendoscopy over RB for detection of SIM, LGD, and, more importantly, for detection of HGD and EAC. Application of the technique of MB chromoendoscopy during endoscopic surveillance of patients with BE is controversial. None of the current practice guidelines recommend routine use of chromoendoscopy during endoscopic surveillance of BE, and some experts point out that MB chromoendoscopy is a tedious, cumbersome technique, with
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DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
Presented at Digestive Disease Week 2008, May 17-22, 2008, San Diego, California (Gastrointest Endosc 2008;67:AB172).
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See CME section; p. 1148.