Efficacy of laparoscopic antireflux surgery in patients with Barrett's esophagus

“…This studyÕs regression rate of metaplasia was high (73%) and it suggested the possibility of surgical interventions for BE. Desai et al [11] prospectively followed 68 patients with BE for 30 months (mean) after antireflux surgery. This study demonstrated a total regression of BE in 10 patients.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic treatment of Barrett’s esophagus: long-term results

et al. 2006

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“…Six uncontrolled studies have evaluated the risk of neoplastic progression after antireflux surgery without PPI treatment [55,56,73,74,75,76]. The results of these studies are shown in table 2.…”

Section: Development and Progression Of Dysplasiamentioning

confidence: 94%

Role of Acid Suppression in the Development and Progression of Dysplasia in Patients with Barrett’s Esophagus

Kastelein

Spaander²,

Biermann³

et al. 2011

Dig Dis

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Barrett’s esophagus (BE) usually develops in patients with gastroesophageal reflux disease and therefore it has been suggested that esophageal acid exposure plays an import role in the initiation of BE and its progression towards esophageal adenocarcinoma (EAC). The mechanisms whereby acid exposure causes BE are not completely revealed and the potential role of esophageal acid exposure in carcinogenesis is unclear as well. Since acid exposure is thought to play an important role in the progression of BE, therapies aimed at preventing the development of EAC have primarily focused on pharmacological and surgical acid suppression. In clinical practice, acid suppression is effective in relieving reflux symptoms and decreases esophageal acid exposure in most patients. However, in some individuals, pathological acid exposure persists and these patients continue to be at risk for developing dysplasia or EAC. To date, published trials suggest that acid suppression is able to prevent the development and progression of dysplasia in patients with BE, but definite and compelling proof is still lacking. This article reviews the mechanisms of acid-induced carcinogenesis in BE and the role of acid suppression in the prevention of neoplastic progression.

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“…Desai et al [40] showed that metaplasia and even low-grade dysplasia can both undergo regression after LARS if patients experiment symptomatic relief of their reflux. Another series specifies that if postoperative symptomatic relief is obtained and documented by pH monitoring that proves normal acid exposure in the distal esophagus, BE may undergo regression of metaplasia and even of low-grade dysplasia (i.e.…”

Section: Can Lars Prevent Malignant Transformation Of Barrett's Epithmentioning

confidence: 99%

Laparoscopic Fundoplication for GERD: Are We There Yet?

García-Gallont¹

2008

Dig Dis

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Although proton pump inhibitor treatment remains the first-line treatment for gastroesophageal reflux disease (GERD), the panorama of an indefinitely prolonged medical treatment faces patients and physicians with the need to look for an equivalent, more definitive therapy. Facing global results, after many series have demonstrated the safety of the laparoscopic antireflux surgery procedure in experienced hands, with a low incidence of intra- and postoperative morbidity and a short postoperative hospital stay (averaging 2 days), the immediate benefit as well as the long-term alleviation of symptoms (very good: 82%, good: 92%) seem to justify the place of surgical fundoplication in the therapeutic armamentarium for GERD as a valid alternative to medical treatment. Careful patient selection for surgery, a complete and thorough preoperative workup, an intervention in experienced hands, and a patient well informed about the pros and cons of both medical and surgical therapy are mandatory.

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Efficacy of laparoscopic antireflux surgery in patients with Barrett's esophagus

Cited by 38 publications

References 35 publications

Laparoscopic treatment of Barrett’s esophagus: long-term results

Laparoscopic treatment of Barrett’s esophagus: long-term results

Role of Acid Suppression in the Development and Progression of Dysplasia in Patients with Barrett’s Esophagus

Laparoscopic Fundoplication for GERD: Are We There Yet?

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