Surgical Management of Barrett’s Esophagus

Peyré, Christian G.; Watson, Thomas J.

doi:10.1016/j.gtc.2015.02.013

Cited by 9 publications

(7 citation statements)

References 51 publications

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“…A 360-degree fundoplication is the most common treatment for GERD presently especially for both acid and bile reflux in patients who respond poorly to the proton pump inhibitors. Even regression of Barrett's metaplasia after surgery has become the interest for physicians to advocate the procedure [10] .…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Nissen Rossetti fundoplication: Possibility towards day care anti-reflux surgeries

Bharatam

Raj

Subramanian

et al. 2015

Annals of Medicine &Amp; Surgery

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IntroductionAs we proceed towards more and more day care surgeries we always need to choose patients and procedures within a great deal of safety margin. Anti reflux surgeries are gaining more popularity and awareness and Laparoscopic Nissen Rosetti fundoplication is a safe and effective method of performing them.Methods and observationsOur case series of 25 patients who underwent day care Laparoscopic Nissen Rossetti fundoplication done over a period of 3 years suggests the feasibility and safety of performing day care anti reflux surgeries with no complications.DiscussionSurgical outcomes of procedure are unaffected and the main challenge faced remains pain relief and which can be effectively tackled by local blocks or plain NSAIDs.ResultsLaparoscopic Nissen Rossetti fundoplication is a safe procedure to be offered as day care anti-reflux surgery. We encourage more studies in this regards with appropriate blinding to enforce its possibility as day care surgery and help patients with early recovery and decreasing cost of surgeries.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Nissen Rossetti fundoplication: Possibility towards day care anti-reflux surgeries

Bharatam

Raj

Subramanian

et al. 2015

Annals of Medicine &Amp; Surgery

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“…More recently, endoscopic therapy employing radiofrequency has been suggested as an alternative to surgical treatment, especially in patients with dysplasia or early EAC. 28 The goal of this therapy is to eradicate pathologic mucosa, but reflux is not stopped. Therefore, medical or surgical treatment is necessary to control ongoing reflux.…”

Section: Prevent Progression To Dysplasia or Adenocarcinomamentioning

confidence: 99%

Long-term (18 Years) Results of Patients With Long-segment Barrett Esophagus Submitted to Acid Suppression-duodenal Diversion Operation

et al. 2023

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Objective: To determine late results of AS-DD procedure in long-segment (LSBE) and extralong-segment BE (ELSBE) using subjective and objective measurements to ascertain the histological impact over intestinal metaplasia (IM) and progression to EAC. Summary of Background Data: Barrett esophagus (BE) is a known precursor of esophageal adenocarcinoma (EAC), and Nissen fundoplication has proven to be unable to stop mixed reflux among them. Our group proposed a surgical procedure that handles pathophysiological changes responsible for BE. Methods: This prospective study included 127 LSBE and ELSBE subjects submitted to clinical and functional analyses. They were presented to selective vagotomy, fundoplication, partial gastrectomy with Roux-en-Y reconstruction. The changes in IM were determined in both groups. Results: Follow-up was completed at a mean of 18 years in 81% of the cases. Visick I-II scores were seen in 88% of LSBE and 65% in ELSBE (P < 0.01). There was significant healing of erosive esophagitis and esophageal peptic ulcers, and strictures were resolved in 71%. There was 38% of IM regression in LSBE. Two cases in each group progressed to EAC at a mean of 15 years. Pathologic acid reflux was abolished in 91% and duodenal in 100%. There was a regression of low-grade dysplasia to IM in 80%. Conclusions: AS-DD permanently eliminates pathologic refluxate to the esophagus. The progression to HGD/EAC is lower compared to medical treatment, with an 8-fold reduction in LSBE and 2.2-fold in ELSBE. AS-DD seems to influence IM behaviors, and it is a tool that could reduce and delay progression to EAC.

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“…In patients with T1a esophageal adenocarcinoma, esophagectomy may be indicated in cases with poorly differentiated tumors, lymphovascular invasion, or cases in which ablation is technically difficult or failed [149]. Traditionally, esophagectomy has been viewed as the standard of care for all patients with T1b esophageal adenocarcinoma.…”

Section: Managementmentioning

confidence: 99%