Gastroesophageal reflux disease (GERD) is considered the main etiologic process in the metaplastic development of Barrett's esophagus.
The most serious complication of Barrett's esophagus is the possible dysplastic evolution to esophageal carcinoma.
Many treatments have been described to prevent the progression of Barrett's esophagus.
The outcomes of these interventions are controversial.
Dr Biertho and colleagues from Belgium assessed whether laparoscopic fundoplication for GERD had an impact on the development of Barrett's esophagus.
The research team collected prospective data from patients who were treated with a laparoscopic fundoplication for Barrett's esophagus.
The team analyzed a variety of clinical and pathologic outcomes.
|Laparoscopy demonstrated Barrett's regression in over 50%|
Laparoscopic fundoplications were completed between 1993 and 2001, with a total sample size of 92.
Each patient was diagnosed with GERD associated with Barrett's esophagus confirmed by both endoscopy and biopsy.
The team noted that laparoscopic fundoplication was performed in all patients.
The researchers found that there was no postoperative mortality or major complications from the procedure.
The mean postoperative stay was 3 days.
The research team observed that 76% of the overall sample size were followed up for a mean 4 years.
Of the patients available for follow-up, the team found that 33% had a complete regression of their Barrett's esophagus.
Of these patients, 21% had a decrease in the degree of metaplasia/dysplasia, while 39% had no significant change.
The researchers identified 7% experiencing a progression of the Barrett's esophagus.
The team reported that 5 patients required further procedures for 3 reasons.
The reasons included GERD recurrence in 2 patients, progression of Barrett's esophagus in a further 2 patients, and intrathoracic migration in 1 patient.
The researchers noted that no patients developed high-grade dysplasia or esophageal carcinoma.
Dr Biertho's concludes, “The results of this study suggest that laparoscopic fundoplication offers a safe and effective long-term treatment for Barrett's esophagus.”
“The procedure also demonstrated regression of Barrett's esophagus in more than 50% of the sample size.”