PMID- 26659238
OWN - NLM
STAT- MEDLINE
DCOM- 20170719
LR  - 20220311
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 30
IP  - 9
DP  - 2016 Sep
TI  - Significance of Nissen fundoplication after endoscopic radiofrequency ablation of 
      Barrett's esophagus.
PG  - 3802-7
LID - 10.1007/s00464-015-4677-9 [doi]
AB  - OBJECTIVE: HALO radiofrequency ablation (RFA) has been proven as safe and 
      efficient in eradication of both non- and dysplastic Barrett's esophagus (BE). 
      Definitive post-RFA treatment is yet to be determined. METHODS: RFA was performed 
      in 56 patients with BE, 38 with intestinal metaplasia (IM) and 18 with low-grade 
      dysplasia (LGD), and repeated in case of residual BE. Length of the BE was 
      classified according to C&M criteria. Follow-up included regular upper GI 
      endoscopies with biopsies 6 months, 1 and 2 years after the complete resolution 
      of BE. Patients were divided into two groups regarding post-RFA treatment: those 
      maintaining proton pump inhibitors (PPI) daily and those submitted to 
      laparoscopic Nissen fundoplication (LNF) at least 3 months after BE eradication 
      or synchronous with RFA. RESULTS: There were no perforations or strictures 
      related to RFA. Complete endoscopic resolution of BE was observed in 83.92 % 
      patients (86.84 % IM and 77.77 % LGD), in 25 that maintained PPI and 22 in whom 
      LNF was done. In PPI group, 2-year follow-up revealed BE recurrence in biopsy 
      samples in 20 % of patients, while in LNF group 9.1 % of patients had recurrent 
      IM. In overall sample of patients, no difference was noted regarding the 
      influence of post-RFA treatment (p < 0.423). LNF proved superiority over PPI 
      treatment in patients with long-segment BE (cutoff C > 4 cm, p < 0.021). 
      CONCLUSION: HALO RFA is a safe procedure, with high rate of success in complete 
      eradication of BE in symptomatic GERD patients. LNF provides good protection for 
      neosquamous epithelium and in selected group of patients could be offered as a 
      first line of treatment after HALO RFA.
FAU - Skrobic, Ognjan
AU  - Skrobic O
AD  - Department of Esophageal Surgery, Clinical Center of Serbia, School of Medicine, 
      First Surgical University Hospital, University of Belgrade, Koste Todorovica St 
      6, Belgrade, 11 000, Serbia. skrobico@gmail.com.
FAU - Simic, Aleksandar
AU  - Simic A
AD  - Department of Esophageal Surgery, Clinical Center of Serbia, School of Medicine, 
      First Surgical University Hospital, University of Belgrade, Koste Todorovica St 
      6, Belgrade, 11 000, Serbia.
FAU - Radovanovic, Nebojsa
AU  - Radovanovic N
AD  - Department of Esophageal Surgery, Clinical Center of Serbia, School of Medicine, 
      First Surgical University Hospital, University of Belgrade, Koste Todorovica St 
      6, Belgrade, 11 000, Serbia.
FAU - Ivanovic, Nenad
AU  - Ivanovic N
AD  - Department of Esophageal Surgery, Clinical Center of Serbia, School of Medicine, 
      First Surgical University Hospital, University of Belgrade, Koste Todorovica St 
      6, Belgrade, 11 000, Serbia.
FAU - Micev, Marjan
AU  - Micev M
AD  - Department of Digestive Pathology, Clinical Center of Serbia, School of Medicine, 
      First Surgical University Hospital, University of Belgrade, Belgrade, Serbia.
FAU - Pesko, Predrag
AU  - Pesko P
AD  - Department of Esophageal Surgery, Clinical Center of Serbia, School of Medicine, 
      First Surgical University Hospital, University of Belgrade, Koste Todorovica St 
      6, Belgrade, 11 000, Serbia.
LA  - eng
PT  - Journal Article
DEP - 20151210
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Barrett Esophagus/*surgery
MH  - Catheter Ablation/*methods
MH  - Endoscopy, Digestive System
MH  - Female
MH  - Fundoplication/*methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Proton Pump Inhibitors/therapeutic use
MH  - Recurrence
OTO - NOTNLM
OT  - Barrett's esophagus
OT  - Laparoscopic Nissen fundoplication
OT  - Radiofrequency ablation
EDAT- 2015/12/15 06:00
MHDA- 2017/07/20 06:00
CRDT- 2015/12/15 06:00
PHST- 2015/08/24 00:00 [received]
PHST- 2015/11/14 00:00 [accepted]
PHST- 2015/12/15 06:00 [entrez]
PHST- 2015/12/15 06:00 [pubmed]
PHST- 2017/07/20 06:00 [medline]
AID - 10.1007/s00464-015-4677-9 [pii]
AID - 10.1007/s00464-015-4677-9 [doi]
PST - ppublish
SO  - Surg Endosc. 2016 Sep;30(9):3802-7. doi: 10.1007/s00464-015-4677-9. Epub 2015 Dec 
      10.