Journal of Minimal Access Surgery

ORIGINAL ARTICLE
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Year : 2005  |  Volume : 1  |  Issue : 1  |  Page : 21--28

Does laparoscopic Nissen fundoplication prevent the progression of Barrett俟Q製 oesophagus? Is the length of Barrett俟Q製 a factor?

Fahad Bamehriz, Sanjeev Dutta, Catherine Gill Pottruff, Christopher A Allen, Mehran Anvari 
 Centre for Minimal Access Surgery, McMaster University, Hamilton, Ontario, Canada

Correspondence Address:
Mehran Anvari
50 Charlton Ave E, Hamilton, Ontario, L8N 4A6
Canada

INTRODUCTION: Recent studies have suggested that both laparoscopic and open anti-reflux surgery may produce regression of Barrett俟Q製 mucosa. MATERIAL AND METHODS; We reviewed 21 patients (13M: 8F, mean age 46.73.18 years) with documented Gastroesophageal Reflux Disease (GERD) and Non-dysplastic Barrett俟Q製 esophagus (15 patients ?3 cm segment, 6 patients < 3 cm segment) on long term proton pump inhibitor therapy who underwent laparoscopic Nissen fundoplication (LNF) between 1993 and 2000. All patients had undergone pre and yearly postoperative upper GI endoscopy with 4 quadrant biopsies every 2 cm. All patients also underwent pre- and 6 months postoperative 24-hr pH study, esophageal manometry, SF36, and GERD symptom score. The mean duration of GERD symptoms was 8.41.54 years pre-operative. The mean follow-up after surgery was 396.32 months. RESULTS: Postoperatively, there was significant improvement in reflux symptom score (37.5 3.98 points versus 8.7 2.46 points, P = 0.0001), % acid reflux in 24 hr (26.5 3.91% versus 2.1 0.84%, P< 0.0001) and an increase in lower esophageal sphincter pressure (3.71 1.08 mmHg versus 12.29 1.34 mmHg, P = 0.0053). Complete or partial regression of Barrett俟Q製 mucosa occurred in 9 patients. All patients with complete regression had <4 cm segment of Barrett俟Q製. Progression or cancer transformation was not observed in any of the patients. CONCLUSION: LNF in patients with Barrett俟Q製 oesophagus results in significant control of GERD symptoms. LNF can prevent progression of Barrett俟Q製 oesophagus and in patients with Barrett俟Q製 <4 cm may lead to complete regression.


How to cite this article:
Bamehriz F, Dutta S, Pottruff CG, Allen CA, Anvari M. Does laparoscopic Nissen fundoplication prevent the progression of Barrett's oesophagus? Is the length of Barrett's a factor?.J Min Access Surg 2005;1:21-28


How to cite this URL:
Bamehriz F, Dutta S, Pottruff CG, Allen CA, Anvari M. Does laparoscopic Nissen fundoplication prevent the progression of Barrett's oesophagus? Is the length of Barrett's a factor?. J Min Access Surg [serial online] 2005 [cited 2021 Mar 5 ];1:21-28
Available from: https://www.journalofmas.com/article.asp?issn=0972-9941;year=2005;volume=1;issue=1;spage=21;epage=28;aulast=Bamehriz;type=0