ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2012
Long-term follow-up of Barrett's epithelium: medical versus antireflux surgical therapy.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.
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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.
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Who cites it
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Fundoplication is superior to medical therapy for Barrett's esophagus disease regression and progression: a systematic review and meta-analysis.Surgical endoscopy · 2022Pooled it
- Surgical treatment of GERD: systematic review and meta-analysis.Surgical endoscopy · 2021Pooled it
- Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015.Journal of gastroenterology · 2016Guideline
- EAES recommendations for the management of gastroesophageal reflux disease.Surgical endoscopy · 2014Guideline
- Diagnostic Accuracy of High-Resolution Manometry for Assessing Fundoplication Integrity: Validation of the Padova Classification.Neurogastroenterology and motility · 2026Article
- Review
- Antireflux Surgery's Lifespan: 20 Years After Laparoscopic Fundoplication.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Superior Mesenteric Artery Syndrome: a Prospective Study in a Single Institution.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019Article
- Study of the prevalence of gastroesophageal reflux symptoms and the role of each in relation to the GERD Impact Scale, based on a population of patients admitted for laparoscopic surgery compared to a control group.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2018Article
- A modified Nissen fundoplication: subjective and objective midterm results.Langenbeck's archives of surgery · 2018Article
- Risk stratification for malignant progression in Barrett's esophagus: Gender, age, duration and year of surveillance.World journal of gastroenterology · 2016Article
- Barrett's esophagus in 2016: From pathophysiology to treatment.World journal of gastrointestinal pharmacology and therapeutics · 2016Review
- BOB CAT: A Large-Scale Review and Delphi Consensus for Management of Barrett's Esophagus With No Dysplasia, Indefinite for, or Low-Grade Dysplasia.The American journal of gastroenterology · 2015Review
- Precision prevention of oesophageal adenocarcinoma.Nature reviews. Gastroenterology & hepatology · 2015Review
- Antireflux surgery for dysplastic Barrett.World journal of surgery · 2015Review
- MAL hypermethylation is a tissue-specific event that correlates with MAL mRNA expression in esophageal carcinoma.Scientific reports · 2013Article
- Review on novel concepts of columnar lined esophagus.Wiener klinische Wochenschrift · 2013Review
- Is the advanced age a contraindication to GERD laparoscopic surgery? Results of a long term follow-up.BMC surgery · 2013Observational
Corrections and comments
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Authors and funding
15 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBarrett's esophagus (BE) is the most serious complication of GERD. In BE patients, this observational study compares the effects of antireflux surgery versus antisecretory medical therapy.
methodsOverall, 89 BE patients (long BE = 45; short BE = 44) were considered: 45 patients underwent antireflux surgery and 44 underwent medical therapy. At both initial and follow-up endoscopy, symptoms were assessed using a detailed questionnaire; BE phenotypic changes [intestinal metaplasia (IM) presence/type, Cdx2 expression] were assessed by histology (H&E), histochemistry (HID), and immunohistochemistry. Surgical failures were defined as follows: (1) abnormal 24-h pH monitoring results after surgery, (2) endoscopically evident recurrent esophagitis, and (3) recurrent hiatal hernia or slipped fundoplication on endoscopy or barium swallow.
resultsReversion of IM was observed in 12/44 SSBE and 0/45 LSBE patients (p < 0.01). Reversion was more frequently observed after effective antireflux surgery than after medical treatment (p = 0.04). In patients with no further evidence of IM after therapy, Cdx2 expression was also absent (p = 0.02). The extent of IM was reduced, and the IM phenotype improved in SSBE patients after surgery.
conclusionsPatients with short BE (but not those with long BE) may benefit from surgically reducing the esophagus' exposure to GE reflux; among these patients, successful surgery carries a higher IM reversion rate than medical treatment.
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Registered trials
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