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Abstract：
Multiple guidelines on Barrett\'s esophagus (BE) have being published in order to standardize and improve clinical practice. However, studies have shown poor adherence to them. Our aim was to synthetize, compare, and assess the quality of recommendations from recently published guidelines, stressing similarities and differences. We conducted a search in Pubmed and Scopus. When different guidelines from the same society were identified, the most recent one was considered. We used the GRADE system to assess the quality of evidence. We included 24 guidelines and position/consensus statements from the European Society of Gastrointestinal Endoscopy, British Society of Gastroenterology, American Society for Gastrointestinal Endoscopy, American Gastroenterological Association, American College of Gastroenterology, Australian guidelines, and Asia-Pacific consensus. All guidelines defend that BE should be diagnosed when there is an extension of columnar epithelium into the distal esophagus. However, there is still some controversy regarding length and histology criteria for BE diagnosis. All guidelines recommend expert pathologist review for dysplasia diagnosis. All guidelines recommend surveillance for non-dysplastic BE, and some recommend surveillance for indefinite dysplasia. While the majority of guidelines recommend ablation therapy for low-grade dysplasia without visible lesion, others recommend ablation therapy or endoscopic surveillance. However, controversy exists regarding surveillance intervals and biopsy protocols. All guidelines recommend endoscopic resection followed by ablation therapy for neoplastic visible lesion. Several guidelines use the GRADE system, but the majority of recommendations are based on low and moderate quality of evidence. Although there is considerable consensus among guidelines, there are some discrepancies resulting from low-quality evidence. The lack of high-quality evidence for the majority of recommendations highlights the importance of continued well-conducted research in this field.
摘要：
为了规范和改善临床实践，已发布了有关Barrett食管（BE）的多项指南。然而,研究表明，对它们的依从性较差。我们的目标是合成，比较,并评估最近发布的指南中建议的质量，强调异同。我们在Pubmed和Scopus进行了搜索。当来自同一社会的不同准则被确定时，最近的一个被认为。我们使用评分系统来评估证据的质量。我们纳入了来自欧洲胃肠内窥镜学会的24条指南和立场/共识声明，英国胃肠病学会，美国胃肠内窥镜学会，美国胃肠病学协会,美国胃肠病学学院,澳大利亚指南，亚太共识。所有指南都认为，当柱状上皮延伸到远端食道时，应诊断为BE。然而,关于BE诊断的长度和组织学标准仍存在一些争议.所有指南都建议专家病理学家对发育不良的诊断进行审查。所有指南都建议对非发育不良的BE进行监测，有些人建议对不确定的发育不良进行监测。虽然大多数指南建议对无可见病变的低度发育不良进行消融治疗，其他人推荐消融治疗或内镜监测.然而,关于监测间隔和活检方案存在争议.所有指南都建议内镜切除，然后消融治疗肿瘤可见病变。一些准则使用等级系统，但大多数建议是基于低质量和中等质量的证据.尽管准则之间有相当多的共识，由于证据质量低，存在一些差异。大多数建议缺乏高质量的证据，突出了在这一领域继续进行良好研究的重要性。
