Barrett's esophagus control after antireflux surgery
Ochando Cerdán, F.; Hernández García-Gallardo, D.; Moreno González, E.
Revista Espanola de Enfermedades Digestivas Organo Oficial de la Sociedad Espanola de Patologia Digestiva 94(4): 188-200
2002
ISSN/ISBN: 1130-0108 PMID: 12185930 Document Number: 548870
Objective: to study the esophageal motor disorders in patients with Barrett's esophagus after surgical treatment. Design: from January 1993 to September 1998 a prospective study with 25 patients referred to our service for surgical treatment of Barrett's esophagus was conducted. Barium transit, endoscopy, 24-hour monitoring of intraluminal pH and stationary esophageal manometry were carried out in all patients pre- and postoperatively. The results were compared before and after surgery. A p<0.05 was considered statistically significant. Patients: 18 male (72%) and 7 women (28%). Mean age was 54.20+-13.29 years (range: 25-71 years). The most frequent clinical manifestation was heartburn (92%). A laparotomy procedure was performed in 68% (n=17) and laparoscopy in 32% (n=8) of patients. A 360degree fundoplication was always performed. Results: 96% of patients presented a defective lower esophageal sphincter. The statistical study demonstrated significant differences after surgery for all pH-metric parameters and lower esophageal sphincter (p<0.01), except for relaxation (p=0.465). In the esophageal body, the statistical study only demonstrated significant differences for mean pressure of the peristaltic waves in segment I (p=0.038) and mean rate of non-transmitted waves in esophageal segment IV-V (p=0.031). Conclusions: antireflux surgery in Barrett's esophagus contributes to the control of gastroesophageal reflux improving esophageal clearing and with significant differences for the mean rate of non-transmitted waves in the distal esophagus.