title: Two-year subjective, objective, quality of life, and endoscopic follow-up after laparoscopic Nissen-Rossetti in patients with columnar-lined esophagus.
abstract: BACKGROUND
  Barrett esophagus (BE) is a complication of gastroesophageal reflux disease. We wish to determine the effects of surgery on the histology of the esophageal mucosa and evaluate Quality of Life.
  
  
  METHODS
  Twenty-seven patients with columnar-lined esophagus (CLE) metaplasia underwent laparoscopic Nissen-Rossetti fundoplication. Patients were submitted to close follow-up.
  
  
  RESULTS
  One patient voluntarily left follow-up after surgery. CLE was still present in 18 patients (66.6%); no patient developed dysplasia or esophageal adenocarcinoma. Two patients with gastric metaplasia and 1 patient with intestinal metaplasia had regression at 12 and 24 months after surgery (11.1%). DeMeester and Johnson score decreased from 38.69 (SD ± 51.44) to 11.99 (SD ± 18.08) at 6 months, 12.69 (SD ± 12.91) at 12 months, and it was 11.38 (SD ± 6.43) at 24 months. Preoperative gastroesophageal reflux disease-health related quality of life was 19.90 (SD ± 18.54), 9.80 (SD ± 8.77) at 6 months, 9.57 (SD ± 9.14) at 12 months, and 11.53 (SD ± 6.48) at 24 months. Short form-36 measurement showed significant improvement.
  
  
  CONCLUSIONS
  Management of CLE requires multidisciplinary approach. Medical therapy does not prevent biliary reflux into the esophagus. Surgical therapy is effective and long lasting. It should be performed by experienced surgical teams.
authors.affiliation: Referral Center for Surgical Treatment of Gastroesophageal Reflux Diseases, Department of Surgery F. Durante, Policlinico Umberto I , Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Marano
authors.forename: Stefano
authors.initials: S
authors.lastname: Mattacchione
authors.forename: Barbara
authors.initials: B
authors.lastname: Luongo
authors.forename: Valentina
authors.initials: V
authors.lastname: Mingarelli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Campagna
authors.forename: Filippo
authors.initials: F
authors.lastname: Tosato
mesh_terms: D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008679:Metaplasia / Q000473:pathology; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult