Is there any relationship between esophageal adenocarcinoma and anti-reflux surgery?

 
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2007 (EN)
Is there any relationship between esophageal adenocarcinoma and anti-reflux surgery? (EN)

H. Nastos, S.N. Sgouros,

SUMMARY Esophageal adenocarcinoma presents a more rapidly rising incidence than all other cancers and arises in most patients from its premalignant precursor, Barrett’s esophagus. Barret’s esophagus is associated with chronic GERD and represents the severest form of this disease. PPIs can markedly decrease acid reflux, but only antireflux surgery can successfully restore the function of the incompetent antireflux barrier. Antireflux surgery may be superior to controlling acid reflux alone, because it also eliminates the possible dangerous contributions of bile salts and pancreatic enzymes. However, current data suggest that both medical and surgical therapies are very effective in symptom relief and healing of esophagitis over the long term, but neither treatment predictably causes Barrett’s metaplasia to regress, nor protects the patient from subsequently developing adenocarcinoma of the esophagus. Even if antireflux surgery could prevent esophageal cancer, its use only for this purpose could not be justified because the surgical mortality rate, at least 0,2%, far exceeds the annual incidence of cancer, estimated at 0,07%. Therefore, it seems prudent for gastroenterologists and surgeons to be honest with their patients about the outcomes of current established treatments of GERD. Given this information, and after a thoughtful discussion of both therapies, we believe patients can choose the regimen that best suits their individual needs. Key words: GERD, Barrett’s esophagus, antireflux surgery, esophageal adenocarcinoma. (EN)

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Ελληνική Γαστροεντερολογική Εταιρία (EL)
Hellenic Society of Gastroenterology (EN)

2007-03-19


Hellenic Society of Gastroenterology (EN)

1792-7463
1108-7471
Annals of Gastroenterology; Volume 17, No 1 (2004) (EN)



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