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The effects of laparoscopic Nissen fundoplication on Barrett's esophagus: long-term results.
Scand J Gastroenterol 2012; 47(1):13-21SJ

Abstract

OBJECTIVE

The aim of our study was to conduct a retrospective investigation of the efficacy of laparoscopic Nissen fundoplication in patients with Barrett's esophagus.

MATERIAL AND METHODS

A total of 78 patients with Barrett's esophagus underwent surgery. Patients were divided into three groups on the basis of the preoperative endoscopic biopsies: a non-intestinal group (n = 63) with fundic or cardiac metaplasia, an intestinal group (n = 18) with intestinal metaplasia, and a dysplastic group (n = 7) with low-grade dysplasia. Clinical follow-up was available in the case of 64 patients at a mean of 42 ± 16.9 months after surgery.

RESULTS

Check-up examination revealed total regression of Barrett's metaplasia in 10 patients. Partial regression was seen in 9 cases, no further progression in 34 patients, and progression into cardiac or intestinal metaplasia in 11 patients. No cases of dysplastic or malignant transformation were registered. Where we observed the regression of BE, among the postoperative functional examinations results of manometry (pressure of lower esophageal sphincter) and pH-metry were significantly better compared with those groups where no changes occurred in BE, or progression of BE was found. Discussion. Our results highlight the importance of the cases of fundic and cardiac metaplasia, which can also transform into intestinal metaplasia.

CONCLUSIONS

Antireflux surgery can appropriately control the reflux disease in a majority of the patients who had unsuccessful medical treatment, and it may inhibit the progression and induce the regression of Barrett's metaplasia in a significant proportion of these patients.

Authors+Show Affiliations

Department of Surgery, University of Szeged, Szeged, Hungary.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22150083

Citation

Simonka, Zsolt, et al. "The Effects of Laparoscopic Nissen Fundoplication On Barrett's Esophagus: Long-term Results." Scandinavian Journal of Gastroenterology, vol. 47, no. 1, 2012, pp. 13-21.
Simonka Z, Paszt A, Abrahám S, et al. The effects of laparoscopic Nissen fundoplication on Barrett's esophagus: long-term results. Scand J Gastroenterol. 2012;47(1):13-21.
Simonka, Z., Paszt, A., Abrahám, S., Pieler, J., Tajti, J., Tiszlavicz, L., ... Lázár, G. (2012). The effects of laparoscopic Nissen fundoplication on Barrett's esophagus: long-term results. Scandinavian Journal of Gastroenterology, 47(1), pp. 13-21. doi:10.3109/00365521.2011.639081.
Simonka Z, et al. The Effects of Laparoscopic Nissen Fundoplication On Barrett's Esophagus: Long-term Results. Scand J Gastroenterol. 2012;47(1):13-21. PubMed PMID: 22150083.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of laparoscopic Nissen fundoplication on Barrett's esophagus: long-term results. AU - Simonka,Zsolt, AU - Paszt,Attila, AU - Abrahám,Szabolcs, AU - Pieler,József, AU - Tajti,János, AU - Tiszlavicz,László, AU - Németh,István, AU - Izbéki,Ferenc, AU - Rosztóczy,András, AU - Wittmann,Tibor, AU - Rárosi,Ferenc, AU - Lázár,György, Y1 - 2011/12/08/ PY - 2011/12/14/entrez PY - 2011/12/14/pubmed PY - 2012/5/2/medline SP - 13 EP - 21 JF - Scandinavian journal of gastroenterology JO - Scand. J. Gastroenterol. VL - 47 IS - 1 N2 - OBJECTIVE: The aim of our study was to conduct a retrospective investigation of the efficacy of laparoscopic Nissen fundoplication in patients with Barrett's esophagus. MATERIAL AND METHODS: A total of 78 patients with Barrett's esophagus underwent surgery. Patients were divided into three groups on the basis of the preoperative endoscopic biopsies: a non-intestinal group (n = 63) with fundic or cardiac metaplasia, an intestinal group (n = 18) with intestinal metaplasia, and a dysplastic group (n = 7) with low-grade dysplasia. Clinical follow-up was available in the case of 64 patients at a mean of 42 ± 16.9 months after surgery. RESULTS: Check-up examination revealed total regression of Barrett's metaplasia in 10 patients. Partial regression was seen in 9 cases, no further progression in 34 patients, and progression into cardiac or intestinal metaplasia in 11 patients. No cases of dysplastic or malignant transformation were registered. Where we observed the regression of BE, among the postoperative functional examinations results of manometry (pressure of lower esophageal sphincter) and pH-metry were significantly better compared with those groups where no changes occurred in BE, or progression of BE was found. Discussion. Our results highlight the importance of the cases of fundic and cardiac metaplasia, which can also transform into intestinal metaplasia. CONCLUSIONS: Antireflux surgery can appropriately control the reflux disease in a majority of the patients who had unsuccessful medical treatment, and it may inhibit the progression and induce the regression of Barrett's metaplasia in a significant proportion of these patients. SN - 1502-7708 UR - https://www.unboundmedicine.com/medline/citation/22150083/The_effects_of_laparoscopic_Nissen_fundoplication_on_Barrett's_esophagus:_long_term_results_ L2 - http://www.tandfonline.com/doi/full/10.3109/00365521.2011.639081 DB - PRIME DP - Unbound Medicine ER -