TITLE

Is Esophageal Adenocarcinoma Occurring Late After Antireflux Surgery Due to Persistent Postoperative Reflux?

AUTHOR(S)
Lagergren, Jesper; Viklund, Pernilla
PUB. DATE
March 2007
SOURCE
World Journal of Surgery;Mar2007, Vol. 31 Issue 3, p465
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Gastroesophageal reflux is the main risk factor for esophageal adenocarcinoma, but there is no strong support for a protective effect of antireflux surgery. We tested the hypothesis that esophageal adenocarcinoma that develops with long latency after antireflux surgery might be due to persistent postoperative reflux. A nationwide population-based case-control study in collaboration with 195 relevant Swedish hospital departments and tumor registries during the study period 1995–1997. Frequency-matched control persons were randomly selected from the population register. All study participants were personally interviewed regarding background data, exposures, symptoms, conditions, diseases, surgery, and medications. Differences between cases and controls in the occurrence of daily, long-standing antireflux medication 5 years or later after antireflux surgery were estimated using Fisher’s exact test. One hundred and eighty-nine out of 216 (88%) eligible cases of esophageal adenocarcinoma and 820 of 1,128 (73%) controls were prospectively enrolled. Seven (3.7%) patients and 8 controls had undergone antireflux surgery at least 5 years before the interview. All 7 case patients had Barrett’s mucosa. Four of the case patients had used postoperative antireflux medications continuously (mean duration 10.2 years), while none of the control persons reported such use ( P = 0.026). There was no difference in mean body mass index between patients with and without postoperative reflux ( P = 0.81). No differences between the patients and controls were found regarding age, sex, body mass index, or tobacco smoking status. Esophageal adenocarcinoma occurring late after antireflux surgery might at least partly be due to persistent postoperative reflux. Further research is required to establish the role of antireflux surgery in the etiology of this tumor.
ACCESSION #
24240909

 

Related Articles

  • Screening and Surveillance for Barrett Esophagus in High-Risk Groups: A Cost-Utility Analysis. Inadomi, John M.; Sampliner, Richard; Lagergren, Jesper; Lieberman, David; Fendrick, Mark; Vakil, Nimish // Annals of Internal Medicine;2/4/2003, Vol. 138 Issue 3, p176 

    Determines the cost-effectiveness of screening for Barrett esophagus in patients with gastroesophageal reflux disease (GERD). Use of a decision analytic model; Study of 50-year-old white men with symptoms of GERD; Cost-effectiveness of screening 50-year-old men with symptoms of GERD to detect...

  • Endoscopy for Barrett's Esophagus and Esophageal Adenocarcinoma. Shaheen, Nicholas // American Family Physician;5/1/2004, Vol. 69 Issue 9, p2060 

    Focuses on the endoscopic screening for Barrett's esophagus and esophageal adenocarcinoma in patients with reflux symptoms. Relation of gastroesophageal reflux disease with cancer; Benefits from medical screening tests; Prevalence of Barrett's esophagus in the U.S.

  • Screening for Barrett's Esophagus. DeVault, Kenneth R. // American Family Physician;5/1/2004, Vol. 69 Issue 9, p2061 

    Focuses on the endoscopic screening of Barrett's esophagus. Association between esophageal adenocarcinoma and gastroesophageal reflux disease; Biopsy of esophageal mucosa required for the diagnosis of Barrett's esophagus; Health risk of the routine biopsy of a squamocolumnar junction.

  • Upper endoscopy as a screening and surveillance tool in esophageal adenocarcinoma: a review of the evidence. Shaheen, Nicholas J.; Provenzale, Dawn; Sandler, Robert S. // American Journal of Gastroenterology;Jun2002, Vol. 97 Issue 6, p1319 

    Esophageal adenocarcinoma is a rare cancer that is increasing rapidly in incidence. Because gastroesophageal reflux disease (GERD) is a risk factor for the development of this cancer, endoscopic screening of individuals with GERD symptoms and endoscopic surveillance of those who are found to...

  • Heartburn → Adenocarcinoma of Esophagus. Young, R. L.; Thompson, Jon S. // American Journal of Gastroenterology;Aug1999, Vol. 94 Issue 8, p2007 

    Provides information on a Swedish study which evaluated the association of gastroesophageal reflux and esophageal adenocarcinoma. Patients that were interviewed in the study; Persons with the highest odds ratio for developing esophageal adenocarcinoma; Need for on-going re-examination of the...

  • Surgical trial investigating nocturnal gastroesophageal reflux and sleep (STINGERS). Cohen, J. A.; Arain, A.; Harris, P. A.; Byrne, D. W.; Holzman, M. D.; Sharp, K. W.; Richards, W. O. // Surgical Endoscopy;Mar2003, Vol. 17 Issue 3, p394 

    Background: Nocturnal reflux is important in the pathogenesis of esophagitis. The relationship between reflux and sleep is poorly understood, although data support both paradigms of nocturnal reflux causing arousal and nocturnal arousal allowing reflux. Furthermore, the effect of fundoplication...

  • Reoperative Fundoplications Are Effective Treatment for Dysphagia and Recurrent Gastroesophageal Reflux. Rosemurgy, Alexander S.; Arnaoutakis, Dean J.; Thometz, Donald P.; Binitie, Odion; Giarelli, Natalie B.; Bloomston, Mark; Goldin, Steve G.; Albrink, Michael H. // American Surgeon;Dec2004, Vol. 70 Issue 12, p1061 

    With wide application of antireflux surgery, reoperations for failed fundoplications are increasingly seen. This study was undertaken to document outcomes after reoperative fundoplications. Sixty-four patients, 26 men and 38 women, of average age 55 years ± 15.6 (SD), underwent reoperative...

  • Standardization of Surgical Technique in Antireflux Surgery: The LOTUS Trial Experience. Attwood, Stephen E. A.; Lundell, Lars; Ell, Christian; Galmiche, Jean-Paul; Hatlebakk, Jan; Fiocca, Roberto; Lind, Tore; Eklund, Stefan; Junghard, Ola // World Journal of Surgery;Jun2008, Vol. 32 Issue 6, p995 

    To date, it has been difficult to compare medical therapy for gastroesophageal reflux disease with that of surgical management from a scientific viewpoint, mainly because of the lack of standardization of the operative technique. This study was designed to identify a methodology for...

  • Reoperative laparoscopic paraesophageal herniorrhaphy can produce excellent outcomes. Tsang, Albert W.; Tiwari, Manish M.; Reynoso, Jason F.; Okwuosa, Chris U.; Oleynikov, Dmitry // Surgical Endoscopy;May2011, Vol. 25 Issue 5, p1458 

    Background: Patients undergoing laparoscopic paraesophageal herniorrhaphy present with various esophageal and extraesophageal symptoms. Given a recurrence rate of up to 44%, reoperative intervention is necessary on a number of patients. The goal of this study is to determine whether patients...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics