Trial reportAnnals of surgery2003
Long-term results of a randomized prospective study comparing medical and surgical treatment of Barrett's esophagus.
Trial report in Annals of surgery, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 12 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
66 citing papers in PubMed, 12 syntheses or guidelines pooled it, 237 citations in OpenAlex.
- Guideline
- Fundoplication is superior to medical therapy for Barrett's esophagus disease regression and progression: a systematic review and meta-analysis.Surgical endoscopy · 2022Pooled it
- Magnitude and Time-Trend Analysis of Postendoscopy Esophageal Adenocarcinoma: A Systematic Review and Meta-analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Pooled it
- Surgical treatment of GERD: systematic review and meta-analysis.Surgical endoscopy · 2021Pooled it
- A Systematic Review and Meta-Analysis of the Effect of Roux-en-Y Gastric Bypass on Barrett's Esophagus.Obesity surgery · 2019Pooled it
- Magnitude of Missed Esophageal Adenocarcinoma After Barrett's Esophagus Diagnosis: A Systematic Review and Meta-analysis.Gastroenterology · 2016Pooled it
- ACG Clinical Guideline: Diagnosis and Management of Barrett's Esophagus.The American journal of gastroenterology · 2016Guideline
- EAES recommendations for the management of gastroesophageal reflux disease.Surgical endoscopy · 2014Guideline
- Guidelines for surgical treatment of gastroesophageal reflux disease.Surgical endoscopy · 2010Guideline
- Treatment for Barrett's oesophagus.The Cochrane database of systematic reviews · 2010Pooled it
- A systematic review and meta-analysis of the treatment for Barrett's esophagus.Digestive diseases and sciences · 2008Pooled it
- The effect of antireflux surgery on esophageal carcinogenesis in patients with barrett esophagus: a systematic review.Annals of surgery · 2007Pooled it
- Disintegrin and metalloproteinases (ADAMs) expression in gastroesophageal reflux disease and in esophageal adenocarcinoma.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2017Trial
- Feasibility, safety, and short-term efficacy of the laparoscopic Nissen-Hill hybrid repair.Surgical endoscopy · 2016Trial
- 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
- Trial
- Efficacy of Nissen fundoplication versus medical therapy in the regression of low-grade dysplasia in patients with Barrett esophagus: a prospective study.Annals of surgery · 2006Trial
- Endoscopic ablation of Barrett's esophagus using high power setting argon plasma coagulation: a prospective study.World journal of gastroenterology · 2005Trial
- The Impact of Hiatus Hernia Size on Dysplasia Progression in Patients With Barrett's Esophagus.JGH open : an open access journal of gastroenterology and hepatology · 2026Article
- Review
6 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the results of medical treatment and antireflux surgery in patients with Barrett's esophagus (BE). SUMMARY BACKGROUND DATA: The treatment of choice in BE is still controversial. Some clinical studies suggest that surgery could be more effective than medical treatment in preventing BE from progressing to dysplasia and adenocarcinoma. However, data from prospective comparative studies are necessary to answer this question.
methodsOne hundred one patients were included in a randomized prospective study, 43 with medical treatment and 58 with antireflux surgery. All patients underwent clinical, endoscopic, and histologic assessment. Functional studies were performed in all the operated patients and in a subgroup of patients receiving medical treatment. The median follow-up was 5 years (range 1-18) in the medical treatment group and 6 years (range 1-18) in the surgical treatment group.
resultsSatisfactory clinical results (excellent to good) were achieved in 39 of the 43 patients (91%) undergoing medical treatment and in 53 of the 58 patients (91%) following antireflux surgery. The persistence of added inflammatory lesions was significantly higher in the medical treatment group. The metaplastic segment did not disappear in any case. Postoperative functional studies showed a significant decrease in the median percentage of total time with pH below 4, although 9 of the 58 patients (15%) showed pathologic rates of acid reflux. High-grade dysplasia appeared in 2 of the 43 patients (5%) in the medical treatment group and in 2 of the 58 patients (3%) in the surgical treatment group. In the latter, both patients presented with clinical and pH-metric recurrence. There was no case of malignancy after successful antireflux surgery.
conclusionsThese results show that there are no differences between the two types of treatment with respect to preventing BE from progressing to dysplasia and adenocarcinoma. However, successful antireflux surgery proved to be more efficient than medical treatment in this sense, perhaps because it completely controls acid and biliopancreatic reflux to the esophagus.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.