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Tassi, Valentina; Lugaresi, Marialuisa; Mattioli, Benedetta; Daddi, Niccolò; Di Simone, Massimo; Bassi, Francesco; Mattioli, Sandro

FA02.03: TIMING OF REFLUX ESOPHAGITIS (RE) AND BARRET’S ESOPHAGUS (BE) DEVELOPMENT IN PATIENTS AFFECTED BY GERD AFTER HELLER MYOTOMY FOR ESOPHAGEAL ACHALASIA

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  • Medientyp: E-Artikel
  • Titel: FA02.03: TIMING OF REFLUX ESOPHAGITIS (RE) AND BARRET’S ESOPHAGUS (BE) DEVELOPMENT IN PATIENTS AFFECTED BY GERD AFTER HELLER MYOTOMY FOR ESOPHAGEAL ACHALASIA
  • Beteiligte: Tassi, Valentina; Lugaresi, Marialuisa; Mattioli, Benedetta; Daddi, Niccolò; Di Simone, Massimo; Bassi, Francesco; Mattioli, Sandro
  • Erschienen: Oxford University Press (OUP), 2018
  • Erschienen in: Diseases of the Esophagus
  • Sprache: Englisch
  • DOI: 10.1093/dote/doy089.fa02.03
  • ISSN: 1120-8694; 1442-2050
  • Schlagwörter: Gastroenterology ; General Medicine
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>In order to acquire data on development of RE and BE in patients affected by GERD after Heller myotomy, we investigated a group of these patients who had long term endoscopic follow up. Data acquired in this group and in a group of patients affected by primary GERD and BE were compared.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>In 1973 our group established a research protocol and data base to include patients affected by esophageal diseases observed since 1955 and successively, who were followed up according to defined protocols. A semi quantitative Visick modified scale (RS0 absence; RS3 maximal severity) was adopted for evaluation of reflux symptoms. Among 465 achalasia patients submitted to Heller myotomy in the period 1955–2016, 42 (57.14% men, median age 50 years IQR 44–58 years) post operatively complained grade RS2–3 reflux symptoms and had long term endoscopic/histologic follow up; 42 patients affected by typical GERD and Barret's esophagus, selected according to age and sex with the ‘Frequency matching’ process formed the control group.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Twenty-six patients were submitted to Heller myotomy without antireflux procedure between 1955 and 1977, 16 to Heller-Dor successively. Patients experienced moderate-severe (SR2–3) GER symptoms after a median period of 20 months (IQR 10–86.5 months) since myotomy; in 100% RE was detected after a median period of 34.5 months (IQR 19.25–56.5 months), in 47.61% BE after a median period of 80 months (IQR 52–123 months) since GER symptoms onset. In primary GERD group, in the absence of medical therapy all patients complained of SR2–3 GER symptoms, RE was diagnosed after a median period of 72.5 months (IQR 59.25–120 months) and BE after a median period of 128 months (IQR 91–163.75 months) since GER symptoms onset. Time for RE (P &lt; 0.001) and BE (P = 0.002) development in achalasia patients was significantly shorter with respect to timing in GERD population.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion</jats:title> <jats:p>In achalasia patients myotomy induced Barret's esophagus occurs much earlier than in typical GERD patients. This information should be considered for the treatment of post Heller GERD and for selection of candidates to POEM.</jats:p> </jats:sec> <jats:sec> <jats:title>Disclosure</jats:title> <jats:p>All authors have declared no conflicts of interest.</jats:p> </jats:sec>