Surgical options and outcomes in Barrett's esophagus.
OBJECTIVE
Barrett's esophagus is a complication of chronic gastroesophageal reflux that results in the replacement of normal stratified squamous epithelium in the distal esophagus by metaplastic columnar mucosa and it carries a 30-fold to 125-fold risk of progression to esophageal adenocarcinoma.


RESULTS
Laparoscopic antireflux surgery has proved durable and effective in treating reflux and reflux-related symptoms in patients with Barrett's esophagus. Recent studies have also focused on the histological changes induced in Barrett's epithelium by antireflux surgery. This article reviews the current literature, analysing the impact of antireflux surgery on both the clinical and the histopathological outcomes.


CONCLUSIONS
Recent studies have disproved the widely held assumption that, once established, Barrett's esophagus does not change. Antireflux surgery can achieve a regression of intestinal metaplasia to cardiac mucosa in patients with Barrett's esophagus and may thus alter the natural history of the disease.
Zaninotto
Giovanni
G
Department of General Surgery, S. Giovanni e Paolo Hospital, Venice, and Department of General Surgery & Organ Transplantation, University of Padova, Italy. giovanni.zaninotto@unipd.it
Rizzetto
Christian
C
D001471:Barrett Esophagus / Q000473:pathology / Q000601:surgery*; D004947:Esophagus / Q000473:pathology / Q000601:surgery; D018662:Fundoplication / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008679:Metaplasia