title: Prevalence of Barrett Esophagus in Adolescents and Young Adults With Esophageal Atresia.
abstract: OBJECTIVE
  To study the prevalence of Barrett esophagus (BE) (gastric and/or intestinal metaplasia) in adolescents treated for esophageal atresia (EA).
  
  
  BACKGROUND
  EA patients are at high risk of BE.
  
  
  METHODS
  This multicenter prospective study included EA patients aged 15 to 19 years. All eligible patients were proposed an upper endoscopy with multistaged esophageal biopsies under general anesthesia. Histological suspicion of metaplasia was confirmed centrally.
  
  
  RESULTS
  One hundred twenty patients [mean age, 16.5 years (±1.4)] were included; 70% had been treated for gastroesophageal reflux disease (GERD) during infancy. At evaluation, 8% were undernourished, 41% had received antireflux surgery, and 41% presented with GERD symptoms, although only 28% were receiving medical treatment. Esophagitis was found at endoscopy in 34% and confirmed at histology in 67%. BE was suspected after endoscopy in 37% and was confirmed by histology for 43% of patients (50 gastric and 1 intestinal metaplasia). No endoscopic or histological anomalies were found at the anastomosis site. BE was not significantly related to clinical symptoms. In multivariate analysis, BE was associated with EA without fistula (P = 0.03), previous multiple antireflux surgery (P = 0.04), esophageal dilation (P = 0.04), suspicion of BE at endoscopy (P < 0.001), and histological esophagitis (P = 0.02).
  
  
  CONCLUSIONS
  Patients with EA are at high risk of persistent GERD and BE. The development of BE is related to GERD history. Long-term systematic follow-up of the esophageal mucosa including multistaged biopsies is required, even in asymptomatic patients. (NCT02495051).
authors.affiliation: *Reference Center for Congenital and Malformative Esophageal Disorders, Hôpital Jeanne de Flandre, Lille†Department of Pediatric Surgery, CHU, Strasbourg, France‡Department of Pediatric Gastroenterology, Hôpital Robert Debré, Paris, France§Department of Pediatric Gastroenterology, HFME, Lyon, France¶Department of Pediatric Gastroenterology, CHU, Rennes, France||Department of Pediatric Surgery, CH Départemental Félix Guyon, Saint Denis-La Réunion, France**Department of Pediatric Gastroenterology, Hôpital Mère-Enfants Ste Justine, Montréal, Canada††Pediatric Surgical Service, Centre Hospitalier de Luxembourg, Luxembourg, Grand-Duché du Luxembourg‡‡Department of Pediatric Gastroenterology, AZ VUB, Bruxelles, Belgium§§Department of Pediatric Gastroenterology, CHU, Caen, France¶¶Department of Pediatric Gastroenterology, Hôpital des Enfants, Toulouse, France||||Department of Pediatric Surgery, CHU, Poitiers, France***Department of Pediatric Gastroenterology, Hôpital des Enfants, Bordeaux, France†††Department of Pediatric Gastroenterology, HUDERF, Bruxelles, Belgium‡‡‡Department of Pediatric Surgery, CHU, Angers, France§§§Department of Pediatric Gastroenterology, Hôpital Trousseau, Paris, France¶¶¶Department of Pediatrics, CH, Le Havre, France||||||Department of Pediatric Gastroenterology, HME CHU, Nantes, France****Department of Gastroenterology CHC, Liège, Belgium††††Department of Pediatric Gastroenterology and Hepatology, UCL, Cliniques Universitaires St Luc, Bruxelles, Belgium‡‡‡‡Public Health, Methods in Clinical Research Team, CHU, Strasbourg, France§§§§Centre Biologie Pathologie, Lille, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Schneider
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gottrand
authors.forename: Marc
authors.initials: M
authors.lastname: Bellaiche
authors.forename: François
authors.initials: F
authors.lastname: Becmeur
authors.forename: Alain
authors.initials: A
authors.lastname: Lachaux
authors.forename: Laure
authors.initials: L
authors.lastname: Bridoux-Henno
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Michel
authors.forename: Christophe
authors.initials: C
authors.lastname: Faure
authors.forename: Paul
authors.initials: P
authors.lastname: Philippe
authors.forename: Yvan
authors.initials: Y
authors.lastname: Vandenplas
authors.forename: Claire
authors.initials: C
authors.lastname: Dupont
authors.forename: Anne
authors.initials: A
authors.lastname: Breton
authors.forename: Jean
authors.initials: J
authors.lastname: Gaudin
authors.forename: Thierry
authors.initials: T
authors.lastname: Lamireau
authors.forename: Laurence
authors.initials: L
authors.lastname: Muyshont
authors.forename: Guillaume
authors.initials: G
authors.lastname: Podevin
authors.forename: Sheila
authors.initials: S
authors.lastname: Viola
authors.forename: Valérie
authors.initials: V
authors.lastname: Bertrand
authors.forename: Dominique
authors.initials: D
authors.lastname: Caldari
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Colinet
authors.forename: Catherine
authors.initials: C
authors.lastname: Wanty
authors.forename: Erik
authors.initials: E
authors.lastname: Sauleau
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Leteurtre
authors.forename: Laurent
authors.initials: L
authors.lastname: Michaud
mesh_terms: D000293:Adolescent; D001471:Barrett Esophagus / Q000453:epidemiology*; D001706:Biopsy; D004933:Esophageal Atresia / Q000601:surgery*; D004941:Esophagitis / Q000150:complications; D004945:Esophagoscopy; D005260:Female; D005602:France / Q000453:epidemiology; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult