PMID- 25030477
OWN - NLM
STAT- MEDLINE
DCOM- 20151201
LR  - 20211021
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 29
IP  - 3
DP  - 2015 Mar
TI  - The patterns of reflux can affect regression of non-dysplastic and low-grade 
      dysplastic Barrett's esophagus after medical and surgical treatment: a 
      prospective case-control study.
PG  - 648-57
LID - 10.1007/s00464-014-3713-5 [doi]
AB  - BACKGROUND: To date, therapeutic guidelines and pattern of reflux for patients 
      with no-dysplasia (ND) or low-grade dysplasia (LGD) Barrett's esophagus (BE) 
      remain unclear. We aimed to analyze pattern of reflux and regression of ND- or 
      LGD-BE after medical and surgical treatment. METHODS: We studied a cohort of ND- 
      and LGD-BE patients who underwent laparoscopic total fundoplication and a cohort 
      of ND- and LGD-BE patients managed medically. Patients were matched for age, sex, 
      and disease duration. After 1 year of follow-up at least, all patients underwent 
      upper endoscopy with esophageal biopsies to evaluate any histological changes, as 
      well as manometry and impedance-pH-metry to re-assess reflux patterns. RESULTS: 
      Thirty-seven patients (20 LGD, 17 ND) undergoing laparoscopic fundoplication were 
      enrolled and compared with 25 patients (13 LGD, 12 ND) managed with proton pump 
      inhibitors (PPI). Laparoscopic fundoplication resulted in a better control of 
      both acidic and weakly acidic reflux (P < 0.001) and was associated with a higher 
      probability of reversion for LGD (P < 0.01). Esophageal motility did not differ 
      between surgically and medically treated patients. CONCLUSIONS: In patients with 
      ND- or LGD-BE, laparoscopic fundoplication seems to warrant a better control of 
      all kinds of refluxate and it is associated with a higher likelihood of reversion 
      of both LGD- and ND-BE, compared with PPI therapy.
FAU - Tolone, Salvatore
AU  - Tolone S
AD  - Division of General and Bariatric Surgery, Department of Surgery, Second 
      University of Naples, Via Pansini, 5, 80131, Naples, NA, Italy, 
      salvatore.tolone@unina2.it.
FAU - Limongelli, Paolo
AU  - Limongelli P
FAU - Romano, Marco
AU  - Romano M
FAU - Federico, Alessandro
AU  - Federico A
FAU - Docimo, Giovanni
AU  - Docimo G
FAU - Ruggiero, Roberto
AU  - Ruggiero R
FAU - Brusciano, Luigi
AU  - Brusciano L
FAU - Del Genio, Gianmattia
AU  - Del Genio G
FAU - Docimo, Ludovico
AU  - Docimo L
LA  - eng
PT  - Journal Article
DEP - 20140717
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Barrett Esophagus/diagnosis/physiopathology/*therapy
MH  - Biopsy
MH  - Case-Control Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Fundoplication/*methods
MH  - Humans
MH  - Male
MH  - Manometry
MH  - Middle Aged
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*therapeutic use
MH  - Time Factors
EDAT- 2014/07/18 06:00
MHDA- 2015/12/15 06:00
CRDT- 2014/07/18 06:00
PHST- 2014/02/06 00:00 [received]
PHST- 2014/06/30 00:00 [accepted]
PHST- 2014/07/18 06:00 [entrez]
PHST- 2014/07/18 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - 10.1007/s00464-014-3713-5 [doi]
PST - ppublish
SO  - Surg Endosc. 2015 Mar;29(3):648-57. doi: 10.1007/s00464-014-3713-5. Epub 2014 Jul 
      17.