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Attila Csendes, MD; Italo Braghetto, MD; Patricio Burdiles, MD; Gladys Smok, MD; Ana Henríquez, MTC; Ana Maria Burgos, MD

Arch Surg. 2009;144(10):921-927.

Hypothesis  The results of surgical treatment of patients with long-segment Barrett esophagus (BE) have been extensively reported. However, few publications refer to the results of surgery 5 years after the fact among patients with short-segment BE. This study aimed to determine the late results of 3 surgical procedures in patients with short-segment BE by subjective and objective measurements.

Design  Prospective, nonrandomized study starting on March 1, 1987, and ending on December 31, 2005.

Setting  A prospective, descriptive study of a group of patients.

Patients  A total of 125 patients with short-segment BE underwent 3 operations in different periods: duodenal switch plus highly selective vagotomy and antireflux technique in 31 patients, vagotomy plus partial gastrectomy and Roux-en-Y loop with antireflux surgery in 58 patients, and laparoscopic Nissen fundoplication in 36 patients.

Main Outcome Measures  Late subjective and objective outcomes of the 3 different surgical procedures.

Results  No operative mortality and only 2 postoperative complications (1.6%) occurred. The regression from intestinal metaplasia to cardiac or oxyntocardiac mucosa occurred in 60.8% to 65.4% of the patients, at a mean time of 39 to 56 months after surgery. Visick grading showed Visick grade I or II in 86.3% to 100.0% of the patients. No progression to low- or high-grade dysplasia or adenocarcinoma occurred.

Conclusions  On the basis of these results, laparoscopic Nissen fundoplication seems to be the surgical option for patients with short-segment BE because it is less invasive, has fewer side effects, and produces good results in the long-term follow-up.

Author Affiliations: Departments of Surgery (Drs Csendes, Braghetto, Burdiles and Burgos, and Ms Henríquez) and Pathology (Dr Smok), Clinical Hospital, University of Chile, Santiago.

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Questions Regarding Surgery to Correct Short-Segment BE: Comment on "Late Results of the Surgical Treatment of 125 Patients With Short-Segment Barrett Esophagus"
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Arch Surg. 2009;144(10):927.
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