Towards screening Barrett’s Oesophagus: current guidelines, imaging modalities and future developments

Barrett’s oesophagus is the only known precursor to oesophageal adenocarcinoma (OAC). Although guidelines on the screening and surveillance exist in Barrett’s oesophagus, the current strategies are inadequate. Oesophagogastroduodenoscopy (OGD) is the gold standard method in screening for Barrett’s oesophagus. This invasive method is expensive with associated risks negating its use as a current screening tool for Barrett’s oesophagus. This review explores current definitions, epidemiology, biomarkers, surveillance, and screening in Barrett’s oesophagus. Imaging modalities applicable to this condition are discussed, in addition to future developments. There is an urgent need for an alternative non-invasive method of screening and/or surveillance which could be highly beneficial towards reducing waiting times, alleviating patient fears and reducing future costs in current healthcare services. Vibrational spectroscopy has been shown to be promising in categorising Barrett’s oesophagus through to high-grade dysplasia (HGD) and OAC. These techniques need further validation through multicentre trials

[Treatment of Hepatic Metastases By Surgical Resection]

Surgical resection of hepatic metastases is mainly performed for colo-rectal carcinomas. The natural history of theses metastases shows that their course is variable but death of the patients occurs within one year after discovery of obvious hepatic metastases in 50 % of these patients. Five years survival after complete surgical hepatic resection is reported to be around 20 % in most series. Prognosis is determined by the node involvement of the primary tumour, the degree of local invasion (Dukes classification) and the time of appearance of the liver-metastases (metachronous or synchronous). A better pre- and intra-operative (ultrasound) detection could improve these results