title: Patients with partial gastrectomy and Barrett esophagus are in higher risk to develop esophageal adenocarcinoma than those with Barretts without gastrectomy.
abstract: OBJECTIVE
  Duodenogastric reflux is a possible risk factor for esophageal adenocarcinoma (CA) development. Gastric surgery that destroys or distorts the pylorus is a good model to study the effects of duodenogastric reflux. To define the consequences of gastrectomy in patients with Barrett esophagus (BE).
  
  
  METHODS
  Records of all BE/CA patients examined in Blackpool-Wyre-Fylde area were reviewed. All surviving patients completed validated questionnaires.
  
  
  RESULTS
  Gastrectomy was more prevalent in CA patients (14 (3.6%) BE vs. 15 (13.3%) CA, p=0.0002). Partial gastrectomy was more prevalent in CA patients, (7 (1.8%) BE vs. 10 (8.8%) CA, p=0.0004), while there was no difference in total gastrectomy between the two groups. Persistence of H. pylori infection after gastrectomy and smoking were more frequent among CA patients with gastrectomy. Mean follow-up time in patients with prior gastrectomy was 78 (SD=76.4) months for BE patients and 119.3 (SD=72.9) months for CA patients (p=0.07). In logistic regression analysis gastrectomy, in addition to old age, long-term reflux, absence of hiatal hernia and H. pylori infection were risk factors for CA.
  
  
  CONCLUSIONS
  Gastrectomy and especially partial gastrectomy was more prevalent in CA patients.
authors.affiliation: NIMTS General Hospital, Athens, Greece. tsibofam@yahoo.com
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Tsibouris
authors.forename: Mark T
authors.initials: MT
authors.lastname: Hendrickse
authors.forename: Chrissostomos
authors.initials: C
authors.lastname: Kalantzis
authors.forename: Peter E T
authors.initials: PE
authors.lastname: Isaacs
mesh_terms: D000230:Adenocarcinoma / Q000209:etiology*; D000368:Aged; D001471:Barrett Esophagus / Q000150:complications*; D004938:Esophageal Neoplasms / Q000209:etiology*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies