Source
Department of Surgery, University Hospital Virgen de la Arrixaca, Ctra. Madrid-Cartagena, El Palmar-30120, Murcia, Spain. parricir@huva.es
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.