RT Journal
A1 Csendes A, Braghetto I, Burdiles P, Smok G, Henríquez A, Burgos A
T1 LAte results of the surgical treatment of 125 patients with short-segment barrett esophagus
JF Archives of Surgery
JO Archives of Surgery
YR 2009
FD October 1
VO 144
IS 10
SP 921
OP 927
DO 10.1001/archsurg.2009.83
UL http://dx.doi.org/10.1001/archsurg.2009.83
AB Hypothesis 
    The results of surgical treatment of patients with long-segment Barrett esophagus (BE) have been extensively reported. However, few publications refer to the results of surgery 5 years after the fact among patients with short-segment BE. This study aimed to determine the late results of 3 surgical procedures in patients with short-segment BE by subjective and objective measurements.Design 
    Prospective, nonrandomized study starting on March 1, 1987, and ending on December 31, 2005.Setting 
    A prospective, descriptive study of a group of patients.Patients 
    A total of 125 patients with short-segment BE underwent 3 operations in different periods: duodenal switch plus highly selective vagotomy and antireflux technique in 31 patients, vagotomy plus partial gastrectomy and Roux-en-Y loop with antireflux surgery in 58 patients, and laparoscopic Nissen fundoplication in 36 patients.Main Outcome Measures 
    Late subjective and objective outcomes of the 3 different surgical procedures.Results 
    No operative mortality and only 2 postoperative complications (1.6%) occurred. The regression from intestinal metaplasia to cardiac or oxyntocardiac mucosa occurred in 60.8% to 65.4% of the patients, at a mean time of 39 to 56 months after surgery. Visick grading showed Visick grade I or II in 86.3% to 100.0% of the patients. No progression to low- or high-grade dysplasia or adenocarcinoma occurred.Conclusions 
    On the basis of these results, laparoscopic Nissen fundoplication seems to be the surgical option for patients with short-segment BE because it is less invasive, has fewer side effects, and produces good results in the long-term follow-up.