ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
Clinical and histologic follow-up after antireflux surgery for Barrett's esophagus.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 70 citations in OpenAlex.
- Treatment for Barrett's oesophagus.The Cochrane database of systematic reviews · 2010Pooled it
- The effect of antireflux surgery on esophageal carcinogenesis in patients with barrett esophagus: a systematic review.Annals of surgery · 2007Pooled it
- Medical or surgical management of GERD patients with Barrett's esophagus: the LOTUS trial 3-year experience.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2008Trial
- FAILURE AFTER FUNDOPLICATION: RE-FUNDOPLICATION? IS THERE A ROOM FOR GASTRECTOMY? IN WHICH CLINICAL SCENARIES?Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2019Article
- Antireflux Surgery and Barrett's Esophagus: Myth or Reality?World journal of surgery · 2018Article
- Long-term follow-up of Barrett's epithelium: medical versus antireflux surgical therapy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2012Article
- Effect of medical and surgical treatment of Barrett's metaplasia.World journal of gastroenterology · 2010Review
- Endoscopic endoluminal radiofrequency ablation of Barrett's esophagus in patients with fundoplications.Surgical endoscopy · 2007Article
- Incorporation of Nissen fundoplication in a rat model of duodenoesophageal reflux.Surgical endoscopy · 2007Article
- Regression of low-grade noninvasive neoplasia in barrett's epithelium: should we lower our guard?Annals of surgery · 2007Article
- Controversies in the treatment of gastroesophageal reflux and achalasia.World journal of gastroenterology · 2006Review
- Barrett's epithelium after antireflux surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2005Article
- When fundoplication fails: redo?Annals of surgery · 2005Article
- Does laparoscopic Nissen fundoplication prevent the progression of Barrett's oesophagus? Is the length of Barrett's a factor?Journal of minimal access surgery · 2005Article
- Impact of the biliary diversion procedure on carcinogenesis in Barrett's esophagus surgically induced by duodenoesophageal reflux in rats.Annals of surgery · 2004Article
- How should Barrett's ulceration be treated?Surgical endoscopy · 2004Review
- Barrett's esophagus.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2004Review
- Disparity between symptomatic and physiologic outcomes following esophageal lengthening procedures for antireflux surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2004Article
- Clinical and pathologic response of Barrett's esophagus to laparoscopic antireflux surgery.Annals of surgery · 2003Article
- Barrett's esophagus: now what?Annals of surgery · 2003Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
There are few prospective studies that document the histologic follow-up after antireflux surgery in patients with Barrett's esophagus, as defined by the recently standardized criteria. We report the clinical, endoscopic, and histologic results of patients with Barrett's esophagus followed postoperatively for at least 2 years. Diagnosis of Barrett's esophagus required preoperative endoscopic evidence of columnar-lined epithelium in the esophagus and a biopsy demonstrating specialized intestinal metaplasia, which stains positively with Alcian blue stain. Between April 1993 and November 1998, a total of 104 patients meeting these criteria underwent fundoplication (laparoscopic [n = 84] or open [n = 6] nissen, laparoscopic Toupet [n = 11], laparoscopic Collis-Nissen [n = 1], Collins-Toupet [n = 1] or open Dor [n = 1]). Short-segment Barrett's esophagus (length of intestinal metaplasia <3 cm) was found preoperatively in 34% and low-grade dysplasia in 4% of patients. All patients were contacted yearly by mail, phone, or clinic visit. At a mean follow-up of 4.6 years (range 2 to 7.5 years), 81% of patients had stopped taking antisecretory medications and 97% were satisfied with the results of their operations. Eight patients have undergone reoperation for recurrence of symptoms. Two patients have died and two were excluded from endoscopic biopsy because of portal hypertension. Sixty-six patients complied with the surveillance protocol, and their histologic results were returned to our center. Symptomatic follow-up of the 34 patients who refused surveillance esophagogastro and duodenoscopy revealed two patients who were taking medication for reflux symptoms. None of the patients have developed high-grade dysplasia or esophageal carcinoma during surveillance endoscopy (337 total patient-years of follow-up). The incidence of regression of intestinal metaplasia to cardiac-fundic-type metaplasia after successful antireflux surgery is greater than previously reported. We suspect that this is a result of longer follow-up and the inclusion of patients with short-segment Barrett's esophagus. A substantial number of patients with Barrett's esophagus who are asymptomatic after antireflux surgery refuse surveillance endoscopy.
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