Barrett's esophagus without esophageal stricture does not increase the rate of failure of Nissen fundoplication.
OBJECTIVE
To assess whether the presence of Barrett's esophagus (BE) modifies the results of Nissen fundoplication.


BACKGROUND
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.
Parrilla
Pascual
P
Department of Surgery, University Hospital Virgen de la Arrixaca, Ctra. Madrid-Cartagena, El Palmar-30120, Murcia, Spain. parricir@huva.es
Martínez de Haro
Luisa F
LF
Ortiz
Angeles
A
Munitiz
Vicente
V
Serrano
Andres
A
Torres
Gloria
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000150:complications*; D005260:Female; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017211:Treatment Failure