Long-term Efficacy of Laparoscopic Antireflux Surgery on Regression of Barrett's Esophagus Using BRAVO Wireless pH Monitoring

Knight, Benjamin; Devitt, Peter G.; Watson, David I.; Smith, Lorelle; Jamieson, Glyn G.; Thompson, Sarah K.

doi:10.1097/sla.0000000000002019

Cited by 20 publications

(14 citation statements)

References 41 publications

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“…Thus, it seems justified to consider the impact of treating the cause of the disease, e. g., repair of the antireflux mechanism (i. e., lower esophageal sphincter, diastasis of the musculature of the cura of the diaphragm, and formation of hiatal hernia). Medical therapy alters the acidity of the reflux, but does not alter the amount of reflux per se [ 11 – 13 ]. By contrast, Knight et al.…”

Section: Resultsmentioning

confidence: 99%

“…By contrast, Knight et al. [ 11 ] and Skrobic et al. [ 12 ] demonstrated that functional, effective antireflux surgery fosters the regression of BE and improves the efficacy of RFA in BE segments >4.0 cm [ 11 , 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…[ 11 ] and Skrobic et al. [ 12 ] demonstrated that functional, effective antireflux surgery fosters the regression of BE and improves the efficacy of RFA in BE segments >4.0 cm [ 11 , 12 ]. Thus, the recent data support antireflux surgery for symptomatic GERD and BE before, during, or after RFA [ 3 , 13 ].…”

Section: Resultsmentioning

confidence: 99%

“…Thus, the recent data support antireflux surgery for symptomatic GERD and BE before, during, or after RFA [ 3 , 13 ]. Esophageal manometry and reflux monitoring are recommended for an accurate diagnosis [ 2 , 3 , 11 , 12 ].…”

Section: Resultsmentioning

confidence: 99%

“…Antireflux surgery targets the cause of the disease (impaired function of the antireflux mechanism, hiatal hernia) and stops increased exposure of the esophagus with the mediator of the disease (reflux), which in turn attacks the esophageal mucosa fostering the development of BE, dysplasia, and cancer [ 1 , 11 , 12 ]. In line with this view, a few new studies examined the effect of antireflux surgery on the treatment of BE.…”

Section: Discussionmentioning

confidence: 99%

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Update on the management of Barrett’s esophagus in Austria

Riegler¹,

Kristo

Nikolic

et al. 2017

Eur Surg

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SummaryBackgroundBarrett’s esophagus (BE) is the premalignant manifestation of gastroesophageal reflux disease (GERD). Radiofrequency ablation (RFA) with and without endoscopic resection (ER) is a novel treatment for BE.MethodsHere we present a single-center update of the recommendations of a recent (June 2015) interdisciplinary expert panel meeting on the management of BE with dysplasia as well as cancer-positive and cancer-negative BE. We conducted a PubMed search of studies published in 2016 and 2017 on the topic of BE and RFA.ResultsOur update reconfirms that BE positive for T1a cancer as well as low- and high-grade dysplasia justifies the use of RFA ± ER, offering an 80–100% rate of BE clearance. RFA ± ER of dysplastic BE is tenfold more effective for cancer prevention when compared with surveillance. Risk factors for recurrence and follow-up treatments include baseline histopathology (dysplasia/T1a cancer), esophagitis, hiatal hernia >3 cm, smoking habits, BE segments >3 cm, and >10 years of GERD symptoms. A baseline diagnosis for dysplasia and T1a cancer should include a second expert pathologist opinion. Recent data justify the use of RFA for nondysplastic BE only in controlled clinical trials. Antireflux surgery can be offered to those with function-test-proven, GERD-symptom-positive BE before, during, or after RFA ± ER. Additionally, there is growing evidence that the intake of a sugar-rich diet is positively correlated with the development of GERD, BE, and cancer.ConclusionRFA ± ER should be offered for dysplastic BE and T1a cancer after ER as well as for nondysplastic BE with additional risk factors in controlled trials. Antireflux surgery can be offered to patients with function-test-proven GERD-symptom-positive BE. Diet considerations should be included in the management of GERD and BE.

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Section: Resultsmentioning

confidence: 99%