Late results of the surgical treatment of 125 patients with short-segment Barrett esophagus.
OBJECTIVE
The results of surgical treatment of patients with long-segment Barrett esophagus (BE) have been extensively reported. However, few publications refer to the results of surgery 5 years after the fact among patients with short-segment BE. This study aimed to determine the late results of 3 surgical procedures in patients with short-segment BE by subjective and objective measurements.


METHODS
Prospective, nonrandomized study starting on March 1, 1987, and ending on December 31, 2005.


METHODS
A prospective, descriptive study of a group of patients.


METHODS
A total of 125 patients with short-segment BE underwent 3 operations in different periods: duodenal switch plus highly selective vagotomy and antireflux technique in 31 patients, vagotomy plus partial gastrectomy and Roux-en-Y loop with antireflux surgery in 58 patients, and laparoscopic Nissen fundoplication in 36 patients.


METHODS
Late subjective and objective outcomes of the 3 different surgical procedures.


RESULTS
No operative mortality and only 2 postoperative complications (1.6%) occurred. The regression from intestinal metaplasia to cardiac or oxyntocardiac mucosa occurred in 60.8% to 65.4% of the patients, at a mean time of 39 to 56 months after surgery. Visick grading showed Visick grade I or II in 86.3% to 100.0% of the patients. No progression to low- or high-grade dysplasia or adenocarcinoma occurred.


CONCLUSIONS
On the basis of these results, laparoscopic Nissen fundoplication seems to be the surgical option for patients with short-segment BE because it is less invasive, has fewer side effects, and produces good results in the long-term follow-up.
Csendes
Attila
A
Department of Surgery, Clinical Hospital, University of Chile, Santos Dumont 999, Santiago, Chile. acsendes@redclinicauchile.cl
Braghetto
Italo
I
Burdiles
Patricio
P
Smok
Gladys
G
Henríquez
Ana
A
Burgos
Ana Maria
AM
D000713:Anastomosis, Roux-en-Y; D001471:Barrett Esophagus / Q000473:pathology* / Q000601:surgery*; D050782:Esophageal pH Monitoring; D005500:Follow-Up Studies; D018662:Fundoplication; D005743:Gastrectomy; D005764:Gastroesophageal Reflux / Q000150:complications / Q000473:pathology / Q000628:therapy*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014629:Vagotomy, Proximal Gastric