Multinational survey on the preferred approach to management of Barrett’s esophagus in the Asia-Pacific region

Table 2 Survey results of respondents within study cohort

Question	Option	Results
Q1. What is your preferred endoscopic landmark of the esophagogastric junction?	Squamo-columnar Junction (Z-line)	42.0%
	Proximal margin of gastric folds	19.5%
	Distal margin of palisade vessels	36.7%
	Diaphragmatic pinch	1.8%
Q2. What is your preferred endoscopic definition of Barrett’s esophagus?	Length of columnar lined epithelium ≥ 2 cm	29.0%
	Length of columnar lined epithelium ≥ 1 cm	22.7%
	Any length of columnar lined epithelium in the esophagus	48.3%
Q3. How often do you use the Prague C and M criteria in your assessment of Barrett’s esophagus?	All the time	16.3%
	> 70% of the time	9.5%
	30%-70% of the time	11.8%
	< 30% of the time	30.1%
	Never	32.3%
Q4. How comfortable are you with endoscopic assessment (white-light with or without advanced imaging technology) in the diagnosis of Barrett’s esophagus?	100% comfortable	13.0%
	> 70% comfortable	45.2%
	30%-70% comfortable	28.8%
	< 30% comfortable	10.5%
	Not at all	2.5%
Q5. What is your preferred histologic definition of Barrett’s esophagus?	Any columnar tissue	37.1%
	Specialized intestinal metaplasia	25.7%
	Gastric metaplasia	17.4%
	No histological confirmation required	19.9%
Q6. In your practice, how regular do you survey your long-segment Barrett’s esophagus without dysplasia?	Every 2 yr	70.8%
	Every 3 yr	13.0%
	Every 5 yr	3.0%
	None at all	13.2%
Q7. How often do you follow the Seattle protocol (i.e. four-quadrant biopsies every 2 cm) in your biopsies of Barrett’s esophagus during surveillance endoscopy?	All the time	6.3%
	> 70% of the time	6.0%
	30%-70% of the time	9.1%
	< 30% of the time	29.9%
	Never	48.7%
Q8. What is your preferred treatment of Barrett’s esophagus without dysplasia?	Lifelong PPI	21.3%
	PPI only when patient has symptoms of gastroesophageal reflux or evidence of esophagitis	74.0%
	Radiofrequency ablation	2.3%
	Anti-reflux procedure (e.g., fundoplication)	2.5%
Q9. For Barrett’s esophagus patients whose biopsies showed indefinite for dysplasia, your preferred approach is:	Confirm with second pathologist and repeat endoscopy after a course of PPI	44.8%
	Surveillance 6-monthly	30.2%
	Surveillance yearly	24.1%
	Surveillance 3-5 yearly	0.9%
Q10. For Barrett’s esophagus patients without a lesion but whose biopsies showed low grade dysplasia, your preferred approach is:	Surveillance 6-monthly	55.5%
	Surveillance yearly	21.3%
	Surveillance 3-5 yearly	1.8%
	Ablative therapy, e.g., radiofrequency, cryotherapy, argon plasma coagulation	9.5%
	Endoscopic mucosal resection	3.9%
	Endoscopic submucosal dissection	8.1%
Q11. For Barrett’s esophagus patients without a lesion but whose biopsies showed high grade dysplasia, your preferred treatment is:	Endoscopic mucosal resection	17.0%
	Endoscopic submucosal dissection	68.2%
	Ablative therapy, e.g., radiofrequency, cryotherapy, argon plasma coagulation	11.2%
	Surgery, e.g., esophagectomy	3.5%

PPI: Proton pump inhibitor.