Barrett's esophagus without esophageal stricture does not increase the rate of failure of Nissen fundoplication

Ann Surg. 2003 Apr;237(4):488-93. doi: 10.1097/01.SLA.0000059971.05281.D2.


Objective: To assess whether the presence of Barrett's esophagus (BE) modifies the results of Nissen fundoplication.

Summary background data: Some authors consider that BE, whether or not there is associated stricture, significantly increases the failure rate of standard antireflux surgery; they recommend using different and more aggressive surgical procedures in all patients with BE.

Methods: One hundred seventy-seven patients with gastroesophageal reflux disease, without esophageal stricture, were included in a retrospective study. Patients were divided into two groups: those with BE (n = 57) and those without BE (n = 120). Nissen fundoplication was performed in all patients by the same surgical team. Clinical, endoscopic, and functional (manometry and 24-hour pH monitoring) results in the two study groups were compared.

Results: After a median follow-up of 5 years (range 1-18) in the BE group and 6 years (range 1-18) in the non-BE group, the rate of clinical recurrence was 8% in the BE group and 10% in the non-BE group, with no statistically significant difference. The rate of pH-metric recurrence was the same in both groups (15%).

Conclusions: The presence of BE without esophageal stricture does not increase the rate of failure of Nissen fundoplication.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Barrett Esophagus / complications*
  • Female
  • Fundoplication*
  • Gastroesophageal Reflux / complications*
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Failure