Système gastro-intestinal et digestif

Abstrait

Antireflux Surgery for Esophageal Adenocarcinoma Prevention: Is it Worth it?

Katherine E Perzan and Chin Hur

Barrett’s esophagus is considered a premalignant condition with an annual risk of progression to esophageal adenocarcinoma of 0.1% to 0.3%. Those patients who experience symptoms of reflux have a further increased rate of malignant transformation. Currently, management of gastroesophageal reflux disease consists of acid suppression therapy with antacids, histamine-2 blockers or proton pump inhibitors. Patients who fail medical management may consider antireflux surgery, namely fundoplication. Given the relationship between reflux, Barrett’s esophagus and esophageal adenocarcinoma, the question arises whether patients with Barrett’s esophagus would benefit from antireflux surgery as a primary cancer prevention strategy. Here, we discuss the benefits and risks of antireflux medications and antireflux surgery, and in so doing attempt to answer the question: Should antireflux surgery be recommended for patients with BE, solely for EAC prevention?