LONG-TERM RESULTS OF CLASSIC ANTIREFLUX SURGERY IN 152 PATIENTS WITH BARRETTS-ESOPHAGUS - CLINICAL, RADIOLOGIC, ENDOSCOPIC, MANOMETRIC, ANDACID REFLUX TEST ANALYSIS BEFORE AND LATE AFTER OPERATION

Background. The classic surgical procedure for patients with Barrett's esophagus (BE) has been either Nissen fundoplication or posterior gas tropexy with calibration of the cardia. Methods. The purpose of our st udy was to determine late subjective and objective results of these cl assic surgical techniques in a large number of patients with BE. A tot al of 152 patients were included in this prospective protocol. Results . There was 1 death (0.7%) after operation. The late follow-up of 100 months demonstrated a high percentage of failures among patients with noncomplicated BE (54%) and an even higher figure in patients with com plicated BE (64%). In 15 patients low grade dysplasia appeared at 8 ye ars of follow-up and an adenocarcinoma in 4 patients. Twenty-four-hour pH monitoring demonstrated a decrease in acid reflux into the esophag us, and Bilitec studies also demonstrated a decrease of duodeno-esopha geal reflux, but in all cases with a higher value than the normal limi t. Conclusions. Classic antireflux surgery in patients with BE results in a high percentage of failures at very late follow-up because it ca nnot completely avoid acid and duodenal reflux into the esophagus.