Barrett's esophagus control after antireflux surgery.
OBJECTIVE
To study the esophageal motor disorders in patients with Barrett's esophagus after surgical treatment.


METHODS
From January 1993 to September 1998 a prospective study with 25 patients referred to our service for surgical treatment of Barrett's esophagus was conducted. Barium transit, endoscopy, 24-hour monitoring of intraluminal pH and stationary esophageal manometry were carried out in all patients pre- and postoperatively. The results were compared before and after surgery. A p < 0.05 was considered statistically significant.


METHODS
18 male (72%) and 7 women (28%). Mean age was 54.20 +/- 13.29 years (range: 25-71 years). The most frequent clinical manifestation was heartburn (92%). A laparotomy procedure was performed in 68% (n = 17) and laparoscopy in 32% (n = 8) of patients. A 360 degrees fundoplication was always performed.


RESULTS
96% of patients presented a defective lower esophageal sphincter. The statistical study demonstrated significant differences after surgery for all pH-metric parameters and lower esophageal sphincter (p < 0.01), except for relaxation (p = 0.465). In the esophageal body, the statistical study only demonstrated significant differences for mean pressure of the peristaltic waves in segment I (p = 0.038) and mean rate of non-transmitted waves in esophageal segment IV-V (p = 0.031).


CONCLUSIONS
Antireflux surgery in Barrett's esophagus contributes to the control of gastroesophageal reflux improving esophageal clearing and with significant differences for the mean rate of non-transmitted waves in the distal esophagus.
General Surgery and Digestive Service, Hospital 12 de Octubre, Madrid, Spain. fochando@worldonline.es
F
F
Ochando Cerdán
D
D
Hernández García-Gallardo
E
E
Moreno González
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001471:Barrett Esophagus / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control* / Q000601:surgery; D003627:Data Interpretation, Statistical; D004941:Esophagitis / Q000175:diagnosis / Q000209:etiology; D004943:Esophagogastric Junction / Q000502:physiology; D004945:Esophagoscopy; D004947:Esophagus / Q000502:physiology; D005260:Female; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D008991:Monitoring, Physiologic; D010528:Peristalsis; D012984:Software