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  • Title: Barrett's esophagus without esophageal stricture does not increase the rate of failure of Nissen fundoplication.
    Author: Parrilla P, Martínez de Haro LF, Ortiz A, Munitiz V, Serrano A, Torres G.
    Journal: Ann Surg; 2003 Apr; 237(4):488-93. PubMed ID: 12677144.
    Abstract:
    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.
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