Barrett's esophagus without esophageal stricture does not increase the rate of failure of Nissen fundoplication.

Abstract

OBJECTIVE:

To assess whether the presence of Barrett's esophagus (BE) modifies the results of Nissen fundoplication.

SUMMARY BACKGROUND DATA:

Some authors consider that BE, whether or not there is associated stricture, significantly increases the failure rate of standard antireflux surgery; they recommend using different and more aggressive surgical procedures in all patients with BE.

METHODS:

One hundred seventy-seven patients with gastroesophageal reflux disease, without esophageal stricture, were included in a retrospective study. Patients were divided into two groups: those with BE (n = 57) and those without BE (n = 120). Nissen fundoplication was performed in all patients by the same surgical team. Clinical, endoscopic, and functional (manometry and 24-hour pH monitoring) results in the two study groups were compared.

RESULTS:

After a median follow-up of 5 years (range 1-18) in the BE group and 6 years (range 1-18) in the non-BE group, the rate of clinical recurrence was 8% in the BE group and 10% in the non-BE group, with no statistically significant difference. The rate of pH-metric recurrence was the same in both groups (15%).

CONCLUSIONS:

The presence of BE without esophageal stricture does not increase the rate of failure of Nissen fundoplication.

• Authors: Pascual Parrilla, Luisa F Martínez de Haro, Angeles Ortiz, Vicente Munitiz, Andres Serrano, Gloria Torres
• Journal: Annals of surgery (Ann Surg) Vol. 237 Issue 4 Pg. 488-93 (Apr 2003) ISSN: 0003-4932 [Print] United States
• PMID: 12677144 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Barrett Esophagus (complications)
• Female
• Fundoplication
• Gastroesophageal Reflux (complications, surgery)
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Treatment Failure