1999 Abstract: 2114 5 YEAR FOLLOW UP ON ANTI-REFLUX SURGERY FOR BARRETTīS ESOPHAGITIS
Abstracts 1999 Digestive Disease Week
# 2114
5 YEAR FOLLOW UP ON ANTI-REFLUX SURGERY FOR BARRETTīS ESOPHAGITIS
Morris E. Franklin Jr., Jose Antonio Diaz-E., Richard Otero, Jeffrey L. Glass, Jorge E. Balli, George B. Kazantsev, Leoncio Obregon, Texas EndoSurg Instute, San Antonio, TX
Introduction: The incidence of Barrettīs esophagitis is reported as 10% to 20% of patients with symptomatic GERD (Cameron and Lee)(1); and the treatment remains controversial varying from careful watching and monitoring, laser photoablation, electrosurgical ablation, to frank esophagectomy. Little is written regarding long term follow up on patiens undergoing anti-reflux surgery for Barrettīs esophagitis with careful periodical follow up, including sequential biopsy. Patients and Methods: This report details long-term follow up of a series of patients undergoing anti-reflux surgery (221 patients) of which 39 (17.6%) had Barrettīs esophagitis. This latter group was divided by severity of disease as follows: No dysplasia 33 (84.7%), Mild dysplasia 4 (10.8%), severe dysplasia 2 (4.5%). Results: The average follow up is 39.38 months (range 12-65 months). From the group without dysplasia, all patients had resolution of symptoms. By repeated biopsy 20 (60%) had no Barrett's findings present, while in 13 (40%) Barrett's changes were still identified. The mild dysplasia group had 75% resolution of Barrett's findings, and 25% had no progression. In the group with severe dysplasia, one progressed to cancer (this patient had very severe COPD and refused recommended esophageal resection) and one has not progressed. Conclusion: In this study, anti-reflux surgery seems to result in lack of progression of disease in 97.4% of patients with biopsy proven Barrett's esophagitis. In 87.5% of all patients repeated endoscopy and biopsies demonstrated a complete resolution at specific intervals.