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The Annals of Thoracic Surgery, Vol 49, 724-726, Copyright © 1990 by The Society of Thoracic Surgeons

ARTICLES

Indications for esophagectomy in nonmalignant Barrett's esophagus: a 10- year experience

NK Altorki, DB Skinner, A Segalin, JK Stephens, MK Ferguson and AG Little
Department of Surgery, Cornell Medical College, New York, New York.

Between 1978 and 1988, 88 patients were referred for the surgical treatment of nonmalignant Barrett's esophagus. Nineteen patients required esophageal resection. Male/female ratio was 13:6; age range was 13 to 84 years (mean age, 49.8 years; median age, 40 years). Preoperative studies demonstrated strictures in 11 patients and ulcers in 7. Penetrating Barrett's ulcer resistant to treatment was the indication for resection in 5 patients. Ulcers penetrated to the pericardium (1 patient), pulmonary vein (1), lung (1), and mediastinum (2). Other indications for resection included undilatable strictures (2), previous operations (4), high-grade dysplasia (3), parietal cells lining the esophagus (1), patient's refusal of long-term surveillance (2), and the inability to exclude adenocarcinoma preoperatively (2). Reconstruction was achieved by colon interposition (15) or esophagogastrostomy (4), with one postoperative death. Mean follow-up was 41 months and was 100% complete. Of the 18 patients, 3 have occasional regurgitation but none have any dysphagia or weight loss. Esophageal resection is indicated in a select group of patients with Barrett's esophagus. Absolute indications include a deep penetrating ulcer confirmed intraoperatively, high-grade dysplasia, strong suspicion of cancer, and multiple previous operations. Relative indications include strictures not responding to dilation and young patients refusing long-term surveillance.

This article has been cited by other articles:

				P. G. Guillem, H. L. Porte, A. Saudemont, P. A. Quandalle, and A. J. Wurtz Perforation of Barrett's ulcer: a challenge in esophageal surgery Ann. Thorac. Surg., June 1, 2000; 69(6): 1707 - 1710. [Abstract] [Full Text] [PDF]

				A. G. Little Barrett's Esophagus Ann. Thorac. Surg., July 1, 1996; 62(1): 315 - 315. [Full Text]