Barrett's esophagus: surgical treatments

Rosati, Riccardo; Savarino, Edoardo; Locatelli, Andrea; Ceolin, Martina; Dua, Kulwinder S.; Tatum, Roger P.; Braghetto, Italo; Gyawali, C. Prakash; Hejazi, Reza; McCallum, Richard W.; Sarosiek, Irene; Bonavina, Luigi; Wassenaar, Eelco B.; Jacobson, Brian C.; Canon, Cheri L.; Badaloni, Adolfo; Genio, Gianmattia del

doi:10.1111/j.1749-6632.2011.06051.x

Cited by 4 publications

(2 citation statements)

References 102 publications

(190 reference statements)

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“…Laparoscopic antireflux surgery (LARS) is a well-established and highly efficacious treatment for GERD and has been shown to provide durable relief from the typical reflux symptoms [Papasavas et al 2003]. In particular, the surgical therapy is helpful in allowing the majority of patients suffering from GERD to discontinue acid suppression therapy, to achieve resolution of associated esophagitis, and to arrest or perhaps even reverse the metaplasia/dysplasia induced by frequent exposure of the esophageal mucosa to gastric contents [Oelschlager et al 2003; Parise et al 2011; Rossi et al 2006].…”

Section: Surgical Therapymentioning

confidence: 99%

Optimal treatment of laryngopharyngeal reflux disease

Martinucci

Bortoli

Savarino

et al. 2013

Therapeutic Advances in Chronic Disease

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Laryngopharyngeal reflux is defined as the reflux of gastric content into larynx and pharynx. A large number of data suggest the growing prevalence of laryngopharyngeal symptoms in patients with gastroesophageal reflux disease. However, laryngopharyngeal reflux is a multifactorial syndrome and gastroesophageal reflux disease is not the only cause involved in its pathogenesis. Current critical issues in diagnosing laryngopharyngeal reflux are many nonspecific laryngeal symptoms and signs, and poor sensitivity and specificity of all currently available diagnostic tests. Although it is a pragmatic clinical strategy to start with empiric trials of proton pump inhibitors, many patients with suspected laryngopharyngeal reflux have persistent symptoms despite maximal acid suppression therapy. Overall, there are scant conflicting results to assess the effect of reflux treatments (including dietary and lifestyle modification, medical treatment, antireflux surgery) on laryngopharyngeal reflux. The present review is aimed at critically discussing the current treatment options in patients with laryngopharyngeal reflux, and provides a perspective on the development of new therapies.

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Section: Surgical Therapymentioning

confidence: 99%

Optimal treatment of laryngopharyngeal reflux disease

Martinucci

Bortoli

Savarino

et al. 2013

Therapeutic Advances in Chronic Disease

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“…Laparoscopic Nissen fundoplication (LNF) has been proposed for patients with GERD and BE as an effective and safe therapeutic alternative, especially in cases where inadequate control of reflux symptoms is found during clinical treatment [20][21][22] . Although this may be true, there is still insufficient data related to the changes in esophageal motility and its evolution after surgical treatment of GERD and BE [23][24][25] .…”

Section: Abstract Abstractmentioning

confidence: 99%

Does the nissen fundoplication procedure improve esophageal dysmotility in patients with barrett’s esophagus?

Falcäo

Nasi

Szachnowicz

et al. 2020

Rev. Col. Bras. Cir.

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Objective: to evaluate esophageal dysmotility (ED) and the extent of Barrett’s esophagus (BE) before and after laparoscopic Nissen fundoplication (LNF) in patients previously diagnosed with BE and ED. Methods: twenty-two patients with BE diagnosed by upper gastrointestinal (GI) endoscopy with biopsies and ED diagnosed by conventional esophageal manometry (CEM) were submitted to a LNF, and followed up with clinical evaluations, upper GI endoscopy with biopsies and CEM, for a minimum of 12 months after the surgical procedure. Results : sixteen patients were male (72.7%) and six were females (27.3%). The mean age was 55.14 (± 15.52) years old. and the mean postoperative follow-up was 26.2 months. The upper GI endoscopy showed that the mean length of BE was 4.09 cm preoperatively and 3.91cm postoperatively (p=0.042). The evaluation of esophageal dysmotility through conventional manometry showed that: the preoperative median of the lower esophageal sphincter resting pressure (LESRP) was 9.15 mmHg and 13.2 mmHg postoperatively (p=0.006). The preoperative median of the esophageal contraction amplitude was 47.85 mmHg, and 57.50 mmHg postoperatively (p=0.408). Preoperative evaluation of esophageal peristalsis showed that 13.6% of the sample presented diffuse esophageal spasm and 9.1% ineffective esophageal motility. In the postoperative, 4.5% of patients had diffuse esophageal spasm, 13.6% of aperistalsis and 22.7% of ineffective motor activity (p=0.133). Conclusion: LNF decreased the BE extension, increased the LES resting pressure, and increased the amplitude of the distal esophageal contraction; however, it was unable to improve ED.

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