Antireflux surgery, highly selective vagotomy and duodenal switch procedure: post-operative evaluation in patients with complicated and non-complicated Barrett's esophagus

Antireflux surgery, highly selective vagotomy (HSV) and Roux-en-Y duodenoje junostomy have been suggested for control of pathophysiological factors inv olved in patients with Barrett's esophagus (BE). The aim of this study was to evaluate prospectively the results of this technique in patients with co mplicated (n=21) and non-complicated (n=45) BE. Complete evaluation of esop hageal function, endoscopic histologic and clinical control was carried out before and 2 years after surgery. Post-operative results show recurrence o f ulcer in patients with complicated BE, but no recurrence in patients with non-complicated BE. Preoperative esophageal ulcer and stricture were prese nt in 85.3% and 14.3%, respectively, of patients with complicated BE. In th is group, recurrence of these complications was 38.1% and 9.5% respectively . The technique offers excellent results in patients with non-complicated B E. However, in patients with complicated BE, the recurrence rate is higher, mainly because of the persistence of acid reflux into the esophagus.