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01-03-2015

The patterns of reflux can affect regression of non-dysplastic and low-grade dysplastic Barrett’s esophagus after medical and surgical treatment: a prospective case–control study

Authors: Salvatore Tolone, Paolo Limongelli, Marco Romano, Alessandro Federico, Giovanni Docimo, Roberto Ruggiero, Luigi Brusciano, Gianmattia Del Genio, Ludovico Docimo

Published in: Surgical Endoscopy | Issue 3/2015

Abstract

Background

To date, therapeutic guidelines and pattern of reflux for patients with no-dysplasia (ND) or low-grade dysplasia (LGD) Barrett’s esophagus (BE) remain unclear. We aimed to analyze pattern of reflux and regression of ND- or LGD-BE after medical and surgical treatment.

Methods

We studied a cohort of ND- and LGD-BE patients who underwent laparoscopic total fundoplication and a cohort of ND- and LGD-BE patients managed medically. Patients were matched for age, sex, and disease duration. After 1 year of follow-up at least, all patients underwent upper endoscopy with esophageal biopsies to evaluate any histological changes, as well as manometry and impedance-pH-metry to re-assess reflux patterns.

Results

Thirty-seven patients (20 LGD, 17 ND) undergoing laparoscopic fundoplication were enrolled and compared with 25 patients (13 LGD, 12 ND) managed with proton pump inhibitors (PPI). Laparoscopic fundoplication resulted in a better control of both acidic and weakly acidic reflux (P < 0.001) and was associated with a higher probability of reversion for LGD (P < 0.01). Esophageal motility did not differ between surgically and medically treated patients.

Conclusions

In patients with ND- or LGD-BE, laparoscopic fundoplication seems to warrant a better control of all kinds of refluxate and it is associated with a higher likelihood of reversion of both LGD- and ND-BE, compared with PPI therapy.

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Title: The patterns of reflux can affect regression of non-dysplastic and low-grade dysplastic Barrett’s esophagus after medical and surgical treatment: a prospective case–control study
Authors: Salvatore Tolone
Paolo Limongelli
Marco Romano
Alessandro Federico
Giovanni Docimo
Roberto Ruggiero
Luigi Brusciano
Gianmattia Del Genio
Ludovico Docimo
Publication date: 01-03-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 3/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-014-3713-5

2024 ASCO Annual Meeting

Springer Medicine

The patterns of reflux can affect regression of non-dysplastic and low-grade dysplastic Barrett’s esophagus after medical and surgical treatment: a prospective case–control study

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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