Zaninotto Giovanni, Rizzetto Christian
Department of General Surgery, S. Giovanni e Paolo Hospital, Venice, and Department of General Surgery & Organ Transplantation, University of Padova, Italy.
Curr Opin Gastroenterol. 2007 Jul;23(4):452-5. doi: 10.1097/MOG.0b013e3281299152.
Barrett's esophagus is a complication of chronic gastroesophageal reflux that results in the replacement of normal stratified squamous epithelium in the distal esophagus by metaplastic columnar mucosa and it carries a 30-fold to 125-fold risk of progression to esophageal adenocarcinoma.
Laparoscopic antireflux surgery has proved durable and effective in treating reflux and reflux-related symptoms in patients with Barrett's esophagus. Recent studies have also focused on the histological changes induced in Barrett's epithelium by antireflux surgery. This article reviews the current literature, analysing the impact of antireflux surgery on both the clinical and the histopathological outcomes.
Recent studies have disproved the widely held assumption that, once established, Barrett's esophagus does not change. Antireflux surgery can achieve a regression of intestinal metaplasia to cardiac mucosa in patients with Barrett's esophagus and may thus alter the natural history of the disease.
巴雷特食管是慢性胃食管反流的一种并发症，导致远端食管的正常复层鳞状上皮被化生的柱状黏膜取代，其发展为食管腺癌的风险增加30至125倍。
腹腔镜抗反流手术已被证明在治疗巴雷特食管患者的反流及反流相关症状方面具有持久性和有效性。近期研究还聚焦于抗反流手术引起的巴雷特上皮组织学变化。本文回顾当前文献，分析抗反流手术对临床和组织病理学结果的影响。
近期研究反驳了一种广泛持有的假设，即巴雷特食管一旦形成就不会改变。抗反流手术可使巴雷特食管患者的肠化生逆转为贲门黏膜，从而可能改变该疾病的自然病程。
