A team from Helsinki, Finland, investigated the clinical significance of esophageal histologic findings after antireflux surgery.
40 patients with severe symptomatic gastroesophageal reflux disease (24 men; mean age, 50 years) were included in the randomized, blinded study.
The patients were enrolled between 1992 and 1997, and were followed up for a mean of 8 months.
|Routine esophageal histologic analysis can have limited value.|
|Archives of Surgery|
Two blinded histopathologists analyzed microscopic signs and severity of esophagitis.
The first histopathologist interpreted 69% of 32 postoperative biopsy specimens as normal. It was found that 22% showed mild changes; 3%, moderate changes; and 6%, severe changes of reflux esophagitis.
The second histopathologist interpreted 78% of the postoperative biopsy specimens as normal. 3% were found to show mild changes; 13%, moderate changes; and 6%, severe changes.
Between the first (91%) and second (81%) histopathologist, the absence of esophageal mucosal inflammation correlated best with normalized pH monitoring.
Dr Tuomo K. Rantanen, of the Helsinki University Central Hospital, concluded on behalf of the group, "These findings suggest that the clinical significance of routine esophageal histologic examination after successful fundoplication is limited.
"This is true if other data, such as those from fundic wrap at endoscopy and 24-hour pH monitoring, are normal."