Barrett's esophagus: The role of laparoscopic fundoplication

Abbas, A. E., Deschamps, C., Cassivi, S. D., Allen, M. S., Nichols, F. C., Miller, D. L. and Pairolero, P. C. (2004). Barrett's esophagus: The role of laparoscopic fundoplication. In: 39th Annual Meeting of the Society of Thoracic Surgeons, San Diego CA, United States, (393-396). 31 January - 2 February 2003. doi:10.1016/S0003-4975(03)01352-3


Author Abbas, A. E.
Deschamps, C.
Cassivi, S. D.
Allen, M. S.
Nichols, F. C.
Miller, D. L.
Pairolero, P. C.
Title of paper Barrett's esophagus: The role of laparoscopic fundoplication
Conference name 39th Annual Meeting of the Society of Thoracic Surgeons
Conference location San Diego CA, United States
Conference dates 31 January - 2 February 2003
Journal name Annals of Thoracic Surgery   Check publisher's open access policy
Place of Publication Philadelphia, PA, United States
Publisher Elsevier
Publication Year 2004
Sub-type Fully published paper
DOI 10.1016/S0003-4975(03)01352-3
ISSN 0003-4975
1552-6259
Volume 77
Issue 2
Start page 393
End page 396
Total pages 4
Language eng
Formatted Abstract/Summary
Background. To review our early operative results and endoscopic findings after laparoscopic fundoplication for Barrett's esophagus (BE).

Methods. From January 1995 through December 2000, 49 patients with BE (35 men and 14 women) underwent laparoscopic antireflux surgery. Median age was 54 years (range, 28 to 85 years). No patient had high-grade dysplasia; 6, however, had low-grade dysplasia. All 49 patients had gastroesophageal reflux symptoms. Heartburn was present in 41 patients (84%), dysphagia in 16 (33%), epigastric or chest pain in 9 (18%), and other symptoms in 16 (33%). A Nissen fundoplication was performed in 48 patients and a partial posterior fundoplication in 1. Forty-one patients (84%) had concomitant hiatal hernia repair.

Results. There were no deaths. Complications occurred in 2 patients (4%). Follow-up was complete in 48 patients (98%) and ranged from 1 to 81 months (median, 29 months). Functional results were classified as excellent in 33 patients (69%), good in 9 (19%), fair in 5 (10%), and poor in 1 (2%). Thirty-three patients (67%) underwent postoperative surveillance esophagoscopy with biopsy. Nine patients (18%) had total regression of BE and 3 (6%) had a decrease in total length. In the 6 patients with preoperative low-grade dysplasia, dysplasia was not found in 4, remained unchanged in 1, and progressed to in situ adenocarcinoma in 1.

Conclusions. Laparoscopic fundoplication is effective in controlling symptoms in the majority of patients with BE. While disappearance of BE may occur in some patients, the possibility of developing esophageal adenocarcinoma is not eliminated by laparoscopic fundoplication. Therefore, endoscopic surveillance should continue.
Keyword ANTIREFLUX SURGERY
GASTROESOPHAGEAL-REFLUX
NISSEN FUNDOPLICATION
SURGICAL THERAPY
ADENOCARCINOMAS
SURVEILLANCE
MANAGEMENT
OPERATION
SURVIVAL
IMPACT
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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