Laparoscopic Antireflux Surgery: Are Old Questions Answered? Should It Be Used Conjoined With Endoscopic Therapy for Barrett’s Esophagus?

Han, Shiwei; Low, Donald E.

doi:10.1590/0102-672020210002e1664

Cited by 2 publications

(1 citation statement)

References 61 publications

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“…The most important aspect to be considered with Barrett's esophagus is the risk of potential development of esophageal adenocarcinoma 3,13 . It is estimated that the risk is 30-125 times higher than the general population 15 .…”

Section: Central Messagementioning

confidence: 99%

Risk of Preneoplastic Lesions in Mucosal Projections of Different Sizes of the Columnar Epithelium in the Lower Esophagus

Copetti

et al. 2022

ABCD, arq. bras. cir. dig.

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BACKGROUND: Barrett's esophagus is an acquired condition that predisposes to the development of esophageal adenocarcinoma. AIMS: The aim of this study was to establish an association between the endoscopic and the histopathological findings regarding differently sized endoscopic columnar epithelial mucosa projections in the low esophagus, under 3.0 cm in the longitudinal extent. METHODS: This is a prospective study, including 1262 patients who were submitted to upper gastrointestinal endoscopy in the period from July 2015 to June 2017. The suspicious projections were measured and subdivided into three groups according to the sizes encountered (Group I: <0.99 cm; Group II: 1.0–1.99 cm; and Group III: 2.0–2.99 cm), and biopsies were then performed. RESULTS: There was a general prevalence of suspicious lesions of 6.42% and of confirmed Barrett's lesions of 1.17%, without a general significant statistical difference among groups. However, from Groups I and II to Group III, the differences were significant, showing that the greater the lesion, the higher the probability of Barrett's esophagus diagnosis. The absolute number of Barrett's lesions was 7, 9, and 6 for Groups I, II, and III, respectively. CONCLUSIONS: The findings led to the conclusion that even projections under 3.0 cm present a similar possibility of evolution to Barrett's esophagus. If, on the one hand, short segments are more prevalent, on the other hand, the long segments have the higher probability of Barrett's esophagus diagnosis, which is why biopsies are required in all suspicious segments.

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Section: Central Messagementioning

confidence: 99%

Risk of Preneoplastic Lesions in Mucosal Projections of Different Sizes of the Columnar Epithelium in the Lower Esophagus

Copetti

et al. 2022

ABCD, arq. bras. cir. dig.

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Laparoscopic treatment of recurrent gastroesophageal reflux disease and hiatal hernia after two failed fundoplications: a clinical case.

Gololobov,

Erin,

Ovchinnikova

et al. 2023

jour

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Aim: identification of the main causes of failures of previous surgical interventions and methods of their prevention during the primary surgical treatment of hernia of the esophageal orifice of the diaphragm.Material and methods. To address the scientific inquiry, an extensive review was conducted across global scientific literature focused on the treatment of primary and recurrent hernias of the esophageal orifice of the diaphragm (GPOD). Additionally, a clinical observation is provided, detailing a surgical intervention performed on a patient who had undergone correction for hernia and gastroesophageal reflux disease (GERD) on two prior occasions.Results. The scientific literature reports limited instances of successfull correction of the recurrence of gastroesophageal reflux disease (GERD) and gastroesophageal orifice di- aphragmatic hernias (GPOD) in patients after two fundoplications. The term ‘failed fundo- plication’ is introduced, a concept not yet described in domestic literature. Eliminating the incorrectly formed antireflux mechanism, which leads to a programmed recurrence of GPOD, and implementing technically correct antireflux interventions allow for the achievement of a pronounced clinical effect in patients who have undergone one or more fundoplications, provided there is adequate peristalsis of the esophagus and stomach. In the presented clin- ical case, the surgical procedure is based on the principles of mitigating the consequences of the previous intervention through repeated intervention primarily focused on eliminating gastroesophageal reflux.Conclusion. Repeated antireflux surgical interventions pose a significant challenge in surgical treatment, attributable to multiple factors concurrently. Identifying technical errors during ear- ly antireflux surgical interventions, eliminating them, and establishing an adequate antireflux mechanism contribute to the success of repeated interventions. Standardization of antireflux interventions is imperative, as adherence to the technical aspects of primary surgical interven- tions represents the most effective means to diminish the risk of disease relapse and the fre- quency of subsequent revision antireflux operations.

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Laparoscopic Antireflux Surgery: Are Old Questions Answered? Should It Be Used Conjoined With Endoscopic Therapy for Barrett’s Esophagus?

Abstract: Does the drop in portal pressure after esophagogastric devascularization and splenectomy variation of variceal calibers and the rebleeding rates in schistosomiasis in late follow-up?

Cited by 2 publications

References 61 publications

Risk of Preneoplastic Lesions in Mucosal Projections of Different Sizes of the Columnar Epithelium in the Lower Esophagus

Risk of Preneoplastic Lesions in Mucosal Projections of Different Sizes of the Columnar Epithelium in the Lower Esophagus

Laparoscopic treatment of recurrent gastroesophageal reflux disease and hiatal hernia after two failed fundoplications: a clinical case.

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