Impact of antireflux operation on columnar-lined esophagus
| Autor: | Jean-Yves Mabrut, Jacques Baulieux, Mustapha Adham, Eric De La Roche, Jean-Louis Gaudin, Jean-Christophe Souquet, Christian Ducerf |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty Esophageal Neoplasms Fundoplication Single Center Barrett Esophagus Esophagus medicine Carcinoma Humans Aged Retrospective Studies Metaplasia Esophageal disease business.industry Medical record fungi Remission Induction Intestinal metaplasia Retrospective cohort study Middle Aged medicine.disease digestive system diseases Surgery medicine.anatomical_structure Diagnostic Techniques Digestive System Dysplasia Disease Progression Gastroesophageal Reflux Female business Follow-Up Studies |
| Zdroj: | Journal of the American College of Surgeons. 196(1) |
| ISSN: | 1072-7515 |
| Popis: | Background The effect of antireflux operation on the natural history of columnar-lined esophagus (CLE) is not fully understood. The aim of this study was to assess a single center's experience and review the literature on the impact of antireflux operation on CLE without high-grade dysplasia. Study design The medical records of 26 patients with CLE but without high-grade dysplasia who underwent antireflux operation in our unit were retrospectively analyzed at longterm followup with detailed endoscopic investigation. Thirteen patients presented with intestinal metaplasia (6 had short segments, and 1 had preoperative laser ablation) and 13 without intestinal metaplasia. Results For the group of 13 patients presenting with intestinal metaplasia, the mean endoscopic followup was 74.7 months (median 46 months). Three of six with short-segment lesion and two of seven with circumferential involvement had complete regression of intestinal metaplasia (one after laser therapy). None had progression to dysplasia or carcinoma. For the group of 13 patients without intestinal metaplasia, mean endoscopic followup was 43.9 months (median 28 months). One had complete regression of CLE, and none developed intestinal metaplasia during surveillance. Conclusions Our study suggests that antireflux operation can alter the natural history of CLE, allowing disease stabilization in a substantial proportion of patients. After antireflux operation, total regression of CLE is possible, but in an unpredictable manner. |
| Databáze: | OpenAIRE |
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