Long-term results of classic antireflux surgery in 152 patients with Barrett's esophagus: Clinical, radiologic, endoscopic, manometric, and acid reflux test analysis before and late after operation
Background: The classic surgical procedure for patients with Barrett's esophagus (BE) has been either Nissen fundoplication or posterior gastropexy with calibration of the cardia. Methods: The purpose of our study was to determine late subjective and objective results of these classic surgical...
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Published in | Surgery Vol. 123; no. 6; pp. 645 - 657 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
New York, NY
Mosby, Inc
01.06.1998
Elsevier |
Subjects | |
Online Access | Get full text |
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Summary: | Background: The classic surgical procedure for patients with Barrett's esophagus (BE) has been either Nissen fundoplication or posterior gastropexy with calibration of the cardia.
Methods: The purpose of our study was to determine late subjective and objective results of these classic surgical techniques in a large number of patients with BE. A total of 152 patients were included in this prospective protocol.
Results: There was 1 death (0.7%) after operation. The late follow-up of 100 months demonstrated a high percentage of failures among patients with noncomplicated BE (54%) and an even higher figure in patients with complicated BE (64%). In 15 patients low grade dysplasia appeared at 8 years of follow-up and an adenocarcinoma in 4 patients. Twenty-four–hour pH monitoring demonstrated a decrease in acid reflux into the esophagus, and Bilitec studies also demonstrated a decrease of duodenoesophageal reflux, but in all cases with a higher value than the normal limit.
Conclusions: Classic antireflux surgery in patients with BE results in a high percentage of failures at very late follow-up because it cannot completely avoid acid and duodenal reflux into the esophagus. (Surgery 1998;123:645-57.) |
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ISSN: | 0039-6060 1532-7361 |
DOI: | 10.1016/S0039-6060(98)70202-8 |