Twenty-four-hour pH monitoring is required to confirm acid reflux suppression in patients with Barrett's oesophagus undergoing anti-reflux surgery.
OBJECTIVE
To assess whether relief of gastro-oesophageal reflux symptoms in patients with Barrett's oesophagus who undergo laparoscopic anti-reflux surgery is a reliable indicator of acid suppression.


METHODS
Prospective cohort study.


METHODS
Surgical department of a large district general hospital.


METHODS
Twenty-two patients with Barrett's oesophagus and symptomatic gastro-oesophageal reflux who underwent laparoscopic anti-reflux surgery.


METHODS
Laparoscopic anti-reflux surgery.


METHODS
Postoperative symptom scores and 24-h pH test results.


RESULTS
Twenty-one out of 22 patients had no or minimal residual symptoms postoperatively (Visick I or II). DeMeester symptom scores improved from a median of 5 preoperatively to 0 postoperatively (P < 0.001, Mann-Whitney rank sum test). Eighteen out of 22 patients had postoperative pH studies: three had persisting abnormal acid exposure times postoperatively, but all three were asymptomatic.


CONCLUSIONS
In patients with Barrett's oesophagus, relief of reflux symptoms following laparoscopic anti-reflux surgery is unreliable as an indicator of acid reflux suppression.
Booth
M I
MI
Department of Surgery, Royal Berkshire Hospital, Reading, UK.
Dehn
T C
TC
D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000503:physiopathology* / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011446:Prospective Studies