[Barrett's oesophagus: place of antireflux surgery].
The aim of this study was to review the literature about the effect of antireflux surgery on the metaplasia-dysplasia-adenocarcinoma sequence in patients with Barrett's oesophagus. Antireflux operations (by laparotomy or laparoscopy) can alter the natural history of Barrett's oesophagus, allowing disease stabilization in a substantial proportion of patients without high grade dysplasia at time of surgery. It also may induce complete or partial regression of Barrett's epithelium, especially for short segment of Barrett's oesophagus, but in unpredictable manner. While regression of low-grade dysplasia is commonly observed, histologic progression is rarely observed after effective antireflux surgery. However, ineffective antireflux surgery expose to histologic progression to high-grade dysplasia or adenocarcinoma. These data support the need for a long-term clinical, endoscopic, and histologic follow-up program after antireflux surgery in patients with Barrett's oesophagus.
Mabrut
J-Y
JY
Service de Chirurgie Générale, Digestive et de la Transplantation Hépatique, Hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France. jean-yves.mabrut@chu-lyon.fr
Baulieux
J
J
D000230:Adenocarcinoma / Q000209:etiology / Q000517:prevention & control*; D001471:Barrett Esophagus / Q000601:surgery*; D002471:Cell Transformation, Neoplastic; D013505:Digestive System Surgical Procedures; D004938:Esophageal Neoplasms / Q000209:etiology / Q000517:prevention & control*; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery; D006801:Humans; D011230:Precancerous Conditions; D016896:Treatment Outcome