Barrett's esophagus in patients with gastroesophageal reflux disease. Medical therapy or antireflux surgery?

Minerva Chir. 2002 Aug;57(4):397-402.

Abstract

Barrett's esophagus is the most serious form of gastroesophageal reflux disease. It may develop due to uncontrolled chronic duodenogastroesophageal reflux and represents a premalignant abnormality. The question of the development of Barrett's esophagus and the progression to adenocarcinoma of the esophagus is addressed by comparison of the data available in the literature. A retrospective review of the literature on the outcome of GERD patients after surgical and medical therapy, is made. Surgical therapy is able to eliminate reflux of gastric and duodenal contents and therefore seems to be superior over medical therapy in the prevention of Barrett's esophagus and its progression to invasive cancer. Surgery should be considered in all Barrett's patients especially in young patients, patients with large hiatal hernia, increasing drug doses or noncompliance to medical therapy.

Publication types

  • Review

MeSH terms

  • Adenocarcinoma / etiology
  • Adult
  • Age Factors
  • Aged
  • Barrett Esophagus / complications
  • Barrett Esophagus / prevention & control
  • Barrett Esophagus / surgery*
  • Esophageal Neoplasms / etiology
  • Esophagectomy
  • Fundoplication
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / surgery*
  • Hernia, Hiatal / complications
  • Humans
  • Middle Aged
  • Risk Factors