Ashwin Kurian, MD, Loren Estoesta. SurgOne, P.C. – Denver Esophageal and Stomach Center
INTRODUCTION: Barrett’s esophagus (BE) is a precancerous condition that results from gastroesophageal reflux disease. Recent studies have demonstrated that Cardiac Intestinal Metaplasia (CIM) progresses to endoscopically confirmed Barrett’s over time. The regression rates of ultra-short segment BE and CIM following anti-reflux surgery has not been clearly elucidated.
METHODS: Ultra-short segment BE or CIM was defined by intestinal metaplasia seen on standard endoscopic forceps biopsy of an irregular squamo-columnar junction. Patients who underwent anti-reflux surgery between November 2013 to November 2017, with a preoperative diagnosis of either ultra-short segment BE or CIM were retrospectively reviewed. Patients underwent surgery primarily for symptomatic reflux disease. Index endoscopy, anti-reflux surgery and surveillance endoscopy were all performed by the same surgeon. Standard 4-quadrant forceps biopsy of the squamo-columnar junction were performed both preoperatively and 1 year post fundoplication.
RESULTS: Twenty-seven patients with a diagnosis of ultra-short segment BE or CIM, underwent laparoscopic anti-reflux surgery (9:male; 18:female). Mean age was 57 + 14 years and mean BMI was 28.6 + 5.6. Nine patients were lost to follow-up. The mean length of time for follow-up was 12.3 + 0.76 months. The median length of stay following the laparoscopic fundoplication was 2 + 2.1 days. Nine patients (50%) had regression of intestinal metaplasia on their postoperative surveillance endoscopy.
CONCLUSION: One year after anti-reflux, 50% of patients showed regression of short-segment BE and CIM. The regression of ultra-short segment BE and CIM can be an added benefit of anti-reflux surgery in addition to the resolution of reflux symptoms.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95638
Program Number: P505
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster