| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1990;49:537-542
© 1990 The Society of Thoracic Surgeons
a Departments of Thoracic and Cardiovascular Surgery, Gastroenterology, and Anatomic Pathology, Lahey Clinic Medical Center, Burlington USA
b Division of Thoracic and Cardiovascular Surgery, New England Deaconess Hospital, Boston, Massachusetts USA
* Address reprint requests to Dr Williamson, Department of Thoracic and Cardiovascular Surgery, Lahey Clinic Medical Center, 41 Mall Rd, Burlington, MA 01805.
Regression of Barrett's epithelium after antireflux operations remains a controversial topic. We evaluated the effect of antireflux procedures in patients with Barrett's esophagus on the regression of columnar epithelium and dysplasia and its potential protective effect on the subsequent development of carcinoma. Of the 241 patients with Barrett's esophagus treated at the Lahey Clinic from 1973 to 1989, 37 patients underwent an antireflux operation. Regression was defined at histological evidence of regenerating squamous mucosa that completely or partially replaced the columnar epithelium. Improvement in lower esophageal sphincter pressure to 12 mm Hg or greater occurred in 19 of 26 patients (73%) who had perioperative manometry. Symptomatic relief of esophagitis occurred in 34 of 37 patients (92%). Four patients had partial regression with regenerating squamous mucosa juxtaposed with areas of columnar epithelium. Carcinoma developed in 3 of 37 patients (8.1%). One patient had recurrence of severe symptoms of reflux esophagitis before development of carcinoma. Patients with Barrett' s esophagus who have undergone a successful antireflux operation with symptomatic relief and evidence of improvement in lower esophageal sphincter pressures rarely show regression of Barrett's mucosa and may still be at risk for development of carcinoma. Therefore, the indications for antireflux operation in Barrett's esophagus should remain the same as for other patients with gastroesophageal reflux, but yearly endoscopic and histological surveillance should be continued postoperatively.
This article has been cited by other articles:
|
|
 |
|
  T. K. Desai, K. Krishnan, N. Samala, J. Singh, J. Cluley, S. Perla, and C. W. Howden The incidence of oesophageal adenocarcinoma in non-dysplastic Barrett's oesophagus: a meta-analysis Gut, November 23, 2011; (2011) gutjnl-2011-300730v2. [Abstract] [Full Text]
|
|
|
|
 |
|
 F. Yousef, C. Cardwell, M. M. Cantwell, K. Galway, B. T. Johnston, and L. Murray The Incidence of Esophageal Cancer and High-Grade Dysplasia in Barrett's Esophagus: A Systematic Review and Meta-Analysis Am. J. Epidemiol., August 1, 2008; 168(3): 237 - 249. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P Sharma, S Wani, A P Weston, A Bansal, M Hall, S Mathur, A Prasad, and R E Sampliner A randomised controlled trial of ablation of Barrett's oesophagus with multipolar electrocoagulation versus argon plasma coagulation in combination with acid suppression: long term results. Gut, September 1, 2006; 55(9): 1233 - 1239. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Deviere Barrett's oesophagus: the new endoscopic modalities have a future Gut, March 1, 2005; 54(suppl_1): i33 - i37. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. E. Abbas, C. Deschamps, S. D. Cassivi, M. S. Allen, F. C. Nichols III, D. L. Miller, and P. C. Pairolero Barrett's esophagus: the role of laparoscopic fundoplication Ann. Thorac. Surg., February 1, 2004; 77(2): 393 - 396. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. S. Kaur, R. Ouatu-Lascar, M. B. Omary, and G. Triadafilopoulos Bile salts induce or blunt cell proliferation in Barrett's esophagus in an acid-dependent fashion Am J Physiol Gastrointest Liver Physiol, June 1, 2000; 278(6): G1000 - G1009. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L.-Q. Chen, D. Nastos, C.-Y. Hu, T. S. Chughtai, R. Taillefer, P. Ferraro, and A. C. Duranceau Results of the Collis-Nissen gastroplasty in patients with Barrett s esophagus Ann. Thorac. Surg., September 1, 1999; 68(3): 1014 - 1020. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C P Barham, R L Jones, L R Biddlestone, R H Hardwick, N A Shepherd, and H Barr Photothermal laser ablation of Barrett's oesophagus: endoscopic and histological evidence of squamous re-epithelialisation Gut, September 1, 1997; 41(3): 281 - 284. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. G. Little Barrett's Esophagus Ann. Thorac. Surg., July 1, 1996; 62(1): 315 - 315. [Full Text]
|
|
|
|
 |
|
 M. L. McDonald, V. F. Trastek, M. S. Allen, C. Deschamps, and P. C. Pairolero BARRETT'S ESOPHAGUS: DOES AN ANTIREFLUX PROCEDURE REDUCE THE NEED FOR ENDOSCOPIC SURVEILLANCE? J. Thorac. Cardiovasc. Surg., June 1, 1996; 111(6): 1135 - 1140. [Abstract] [Full Text]
|
|
|
|
|
|
N. C. Poirier, R. Taillefer, P. Topart, and A. Duranceau Antireflux operations in patients with scleroderma Ann. Thorac. Surg., July 1, 1994; 58(1): 66 - 73. [Abstract] [PDF]
|
|
|
|
|
|
M. Pera, V. F. Trastek, P. C. Pairolero, A. Cardesa, M. S. Allen, and C. Deschamps Barrett's disease: Pathophysiology of metaplasia and adenocarcinoma Ann. Thorac. Surg., November 1, 1993; 56(5): 1191 - 1197. [Abstract] [PDF]
|
|
|
|
|
|
J. M. Streitz Jr, W. A. Williamson, and F. H. Ellis Jr Current concepts concerning the nature and treatment of Barrett's esophagus and its complications Ann. Thorac. Surg., September 1, 1992; 54(3): 586 - 591. [Abstract] [PDF]
|
|
|
|
|
|
D. B. Skinner Controversies about Barrett's esophagus Ann. Thorac. Surg., April 1, 1990; 49(4): 523 - 524. [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
