{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T22:50:34Z","timestamp":1773269434161,"version":"3.50.1"},"reference-count":56,"publisher":"International College of Surgeons","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p>Laparoscopic antireflux surgery is very successful in patients with short-segment Barrett's esophagus (BE), but in patients with long-segment BE, the results remain in discussion. In these patients, during the open era of surgery, we performed acid suppression + duodenal diversion procedures added to the antireflux procedure (fundoplication + vagotomy + antrectomy + Roux-en-Y gastrojejunostomy) to obtain better results at long-term follow-up. The aim of this prospective study is to present the results of 3 to 5\u00a0years' follow-up in patients with short-segment and long-segment or complicated BE (ulcer or stricture) who underwent fundoplication or the acid suppression\u2013duodenal diversion technique, both performed by a laparoscopic approach. One hundred eight patients with histologically confirmed BE were included: 58 patients with short-segment BE, and 50 with long-segment BE, 28 of whom had complications associated with severe erosive esophagitis, ulcer, or stricture. After surgery, among patients treated with fundoplication with cardia calibration, endoscopic erosive esophagitis was observed in 6.9% of patients with short-segment BE, while 50% of patients with long-segment BE presented with positive acid reflux, persistence of endoscopic esophagitis with intestinal metaplasia, and progression to dysplasia (in 5% of cases; <jats:italic>P<\/jats:italic> \u200a=\u200a 0.000). On the contrary, after acid suppression\u2013duodenal diversion surgery in patients with long-segment BE, more than 95.6% presented with successful results regarding recurrent symptoms and endoscopic regression of esophagitis. Regression of intestinal metaplasia to the cardiac mucosa was observed in 56.9% of patients with short-segment BE who underwent fundoplication and in 61% of those with long-segment BE treated with the acid suppression\u2013duodenal diversion procedure. Patients with long-segment BE who experienced fundoplication alone presented no regression of intestinal metaplasia; on the contrary, progression to dysplasia was observed in 1 case (<jats:italic>P<\/jats:italic> \u200a=\u200a 0.049). Patients with short-segment BE can be successfully treated with fundoplication, but for patients with long-segment BE, we suggest performance of fundoplication plus an acid suppression\u2013duodenal diversion procedure.<\/jats:p>","DOI":"10.9738\/cc29.1","type":"journal-article","created":{"date-parts":[[2012,12,13]],"date-time":"2012-12-13T18:35:24Z","timestamp":1355423724000},"page":"95-103","source":"Crossref","is-referenced-by-count":13,"title":["Laparoscopic Surgical Treatment for Patients With Short- and Long-Segment Barrett's Esophagus: Which Technique in Which Patient?"],"prefix":"10.9738","volume":"96","author":[{"given":"Italo","family":"Braghetto","sequence":"first","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Owen","family":"Korn","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9ctor","family":"Valladares","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"An\u00edbal","family":"Debandi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Carlos","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Brunet","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Chile, Santiago, Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"4721","reference":[{"issue":"3","key":"i0020-8868-96-2-95-Bammer1","series-title":"Mayo Clin Proc","first-page":"335","article-title":"Rationale for surgical therapy of Barrett's esophagus.","volume":"76","author":"Bammer, T","year":"2001","unstructured":"Bammer, T, HuiderRA, KlausA, TrastekVF, and AchemSR. 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Effect of gastric bypass on Barrett's esophagus and intestinal metaplasia of the cardia in patients with morbid obesity.J Gastrointest Surg2006. 10 (2):259\u2013264."},{"issue":"3","key":"i0020-8868-96-2-95-Braghetto1","series-title":"Dis Esophagus","first-page":"235","article-title":"Histological inflammatory changes after surgery at the epithelium of the distal esophagus in patients with Barrett's esophagus: a comparison of two surgical procedures.","volume":"17","author":"Braghetto, I","year":"2004","unstructured":"Braghetto, I, CsendesA, SmokG, GradizM, MarianiV, CompanA, et al. 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Barrett's esophagus: now what?Ann Surg2003. 237:299\u2013300."},{"issue":"7","key":"i0020-8868-96-2-95-Katzka1","series-title":"Am J Gastroenterol","first-page":"989","article-title":"Successful elimination of reflux symptoms does not insure adequate control of acid reflux in patients with Barrett's esophagus.","volume":"89","author":"Katzka, DA","year":"1994","unstructured":"Katzka, DA and CastellDO. Successful elimination of reflux symptoms does not insure adequate control of acid reflux in patients with Barrett's esophagus.Am J Gastroenterol1994. 89 (7):989\u2013991."},{"key":"i0020-8868-96-2-95-DeMeester1","series-title":"Adv Surg","first-page":"29","article-title":"The diagnosis and management of Barrett's esophagus.","volume":"33","author":"DeMeester, SR","year":"1999","unstructured":"DeMeester, SR and DeMeesterTR. The diagnosis and management of Barrett's esophagus.Adv Surg1999. 33:29\u201368."},{"issue":"2","key":"i0020-8868-96-2-95-Lundell1","series-title":"Am Coll Surg","first-page":"172","article-title":"Continued (5\u00a0years) follow-up of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease.","volume":"192","author":"Lundell, L","year":"2001","unstructured":"Lundell, L, MittinemP, MyrvoldH, PedersenSA, LiedmanB, HatlebakkJG, et al. Continued (5\u00a0years) follow-up of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease.Am Coll Surg2001. 192 (2):172\u2013179; discussion 179\u2013181."},{"issue":"2","key":"i0020-8868-96-2-95-Lundell2","series-title":"Br J Surg","first-page":"198","article-title":"Seven-year follow-up of a randomized clinical trial comparing proton-pump inhibition with surgical therapy for reflux oesophagitis.","volume":"94","author":"Lundell, L","year":"2007","unstructured":"Lundell, L, MiettinenP, MyrvoldHE, HatlebakkJG, WallinL, MalmA, et al. Nordic GORD Study GroupSeven-year follow-up of a randomized clinical trial comparing proton-pump inhibition with surgical therapy for reflux oesophagitis.Br J Surg2007. 94 (2):198\u2013203."},{"issue":"3","key":"i0020-8868-96-2-95-Lundell3","series-title":"Dig Dis","first-page":"188","article-title":"Therapy of gastroesophageal reflux: evidence-based approach to antireflux surgery.","volume":"25","author":"Lundell, L","year":"2007","unstructured":"Lundell, L\n          . Therapy of gastroesophageal reflux: evidence-based approach to antireflux surgery.Dig Dis2007. 25 (3):188\u2013196."},{"issue":"8","key":"i0020-8868-96-2-95-Cameron1","series-title":"Am J Gastroenterol","first-page":"2054","article-title":"Barrett's esophagus: prevalence and size of hiatal hernia.","volume":"94","author":"Cameron, A","year":"1999","unstructured":"Cameron, A\n          . Barrett's esophagus: prevalence and size of hiatal hernia.Am J Gastroenterol1999. 94 (8):2054\u20132059."},{"key":"i0020-8868-96-2-95-Chang1","series-title":"Surg Endosc","first-page":"390","article-title":"The relationship between gastroesophageal reflux disease and its complications with Barrett's esophagus.","volume":"17","author":"Chang, L","year":"2003","unstructured":"Chang, L, EisenGM, SandlerRS, and MurrayS. The relationship between gastroesophageal reflux disease and its complications with Barrett's esophagus.Surg Endosc2003. 17:390."},{"issue":"3","key":"i0020-8868-96-2-95-Oberg1","series-title":"J Thorac Cardiovasc Surg","first-page":"572","article-title":"The extent of Barrett's esophagus depends on the status of the lower esophageal sphincter and the degree of esophageal acid exposure.","volume":"117","author":"Oberg, S","year":"1999","unstructured":"Oberg, S, DemeesterTR, PetersJH, HagenJA, NigroJJ, and DeMeesterSR. The extent of Barrett's esophagus depends on the status of the lower esophageal sphincter and the degree of esophageal acid exposure.J Thorac Cardiovasc Surg1999. 117 (3):572\u2013580."},{"issue":"2","key":"i0020-8868-96-2-95-Abbas1","series-title":"Ann Thorac Surg","first-page":"393","article-title":"Barrett's esophagus: the role of laparoscopic fundoplication.","volume":"77","author":"Abbas, AE","year":"2004","unstructured":"Abbas, AE, DeschampsC, CassiviSD, AllenMS, NicholsFC3rd, MillerDL, et al. Barrett's esophagus: the role of laparoscopic fundoplication.Ann Thorac Surg2004. 77 (2):393\u2013396."},{"issue":"1","key":"i0020-8868-96-2-95-Csendes3","series-title":"Chest Surg Clin N Am","first-page":"157","article-title":"Roux-en-Y, long limb diversion as the first option for patients who have Barrett's esophagus.","volume":"12","author":"Csendes, A","year":"2002","unstructured":"Csendes, A, BraghettoI, BurdilesP, and KornO. Roux-en-Y, long limb diversion as the first option for patients who have Barrett's esophagus.Chest Surg Clin N Am2002. 12 (1):157\u2013184."},{"issue":"11","key":"i0020-8868-96-2-95-Booth1","series-title":"Eur J Gastroenterol Hepatol","first-page":"1323","article-title":"Twenty-four hour pH monitoring is required to confirm acid reflux suppression in patients with Barrett's esophagus undergoing antireflux surgery.","volume":"13","author":"Booth, M","year":"2001","unstructured":"Booth, M and DehnT. Twenty-four hour pH monitoring is required to confirm acid reflux suppression in patients with Barrett's esophagus undergoing antireflux surgery.Eur J Gastroenterol Hepatol2001. 13 (11):1323\u20131326."},{"key":"i0020-8868-96-2-95-Low1","series-title":"Am J Gastroenterol","first-page":"80","article-title":"Esophagus after antireflux surgery.","volume":"4","author":"Low, DE","year":"1999","unstructured":"Low, DE, DevineDS, DailDH, and KozarekRA. Esophagus after antireflux surgery.Am J Gastroenterol1999. 4:80\u201385."},{"issue":"12","key":"i0020-8868-96-2-95-Bell1","series-title":"Surg Endosc","first-page":"1189","article-title":"Patterns of success and failure with laparoscopic Toupet fundoplication.","volume":"13","author":"Bell, R","year":"1999","unstructured":"Bell, R, HannaP, MillsM, and BowreyD. Patterns of success and failure with laparoscopic Toupet fundoplication.Surg Endosc1999. 13 (12):1189\u20131194."},{"issue":"6","key":"i0020-8868-96-2-95-Horvath1","series-title":"J Gastrointest Surg","first-page":"583","article-title":"Laparoscopic Toupet fundoplication is an inadequate procedure patients with severe reflux disease.","volume":"3","author":"Horvath, KD","year":"1999","unstructured":"Horvath, KD, JobeBA, and HerronDM. Laparoscopic Toupet fundoplication is an inadequate procedure patients with severe reflux disease.J Gastrointest Surg1999. 3 (6):583\u2013591."},{"issue":"11","key":"i0020-8868-96-2-95-Jobe1","series-title":"Surg Endosc","first-page":"1080","article-title":"Evaluation of laparoscopic Toupet fundoplication as a primary repair for all patients with medically resistant gastroesophageal reflux.","volume":"11","author":"Jobe, B","year":"1997","unstructured":"Jobe, B, WallaceJ, HansenP, and SwanstronL. Evaluation of laparoscopic Toupet fundoplication as a primary repair for all patients with medically resistant gastroesophageal reflux.Surg Endosc1997. 11 (11):1080\u20131083."},{"issue":"8","key":"i0020-8868-96-2-95-DeMeester2","series-title":"Curr Probl Surg","first-page":"558","article-title":"Barrett's esophagus.","volume":"38","author":"DeMeester, SR","year":"2001","unstructured":"DeMeester, SR, PetersJH, and De MeesterTR. 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Laparoscopic treatment of Barrett's esophagus: long term results.Surg Endosc2007. 21 (1):11\u201315."},{"issue":"4","key":"i0020-8868-96-2-95-Oeschlager1","series-title":"Ann Surg","first-page":"456","article-title":"Clinical and pathological response of Barrett's esophagus to laparoscopic antireflux surgery.","volume":"238","author":"Oeschlager, BK","year":"2003","unstructured":"Oeschlager, BK, BarreraM, ChangL, OleynikovD, and PellegriniCA. Clinical and pathological response of Barrett's esophagus to laparoscopic antireflux surgery.Ann Surg2003. 238 (4):456\u2013466."},{"issue":"10","key":"i0020-8868-96-2-95-Csendes4","series-title":"Arch Surg","first-page":"921","article-title":"Late results of the surgical treatment of 125 patients with short-segment Barrett's esophagus.","volume":"144","author":"Csendes, A","year":"2009","unstructured":"Csendes, A, BraghettoI, BurdilesP, SmokG, HenriquezA, and BurgosAM. Late results of the surgical treatment of 125 patients with short-segment Barrett's esophagus.Arch Surg2009. 144 (10):921\u2013927."},{"issue":"5","key":"i0020-8868-96-2-95-Gursky1","series-title":"J Am Coll Surg","first-page":"706","article-title":"Barrett's esophagus can and does regress after antireflux surgery: a study of prevalence and predictive factors.","volume":"196","author":"Gursky, RR","year":"2003","unstructured":"Gursky, RR, PetersJH, HagenJA, and DeMeesterTR. Barrett's esophagus can and does regress after antireflux surgery: a study of prevalence and predictive factors.J Am Coll Surg2003. 196 (5):706\u2013713."},{"issue":"9","key":"i0020-8868-96-2-95-Zaninotto1","series-title":"J Gastrointest Surg","first-page":"1253","article-title":"Barrett's epithelium after antireflux surgery.","volume":"9","author":"Zaninotto, G","year":"2005","unstructured":"Zaninotto, G, CassaroM, PennelliG, BattagliaG, FarinattiF, CeolinM, et al. Barrett's epithelium after antireflux surgery.J Gastrointest Surg2005. 9 (9):1253\u20131260."},{"issue":"4","key":"i0020-8868-96-2-95-Zaninotto2","series-title":"Curr Opin Gastroenterol","first-page":"452","article-title":"Surgical options and outcome in Barrett's esophagus.","volume":"23","author":"Zaninotto, G","year":"2007","unstructured":"Zaninotto, G and RizettoC. Surgical options and outcome in Barrett's esophagus.Curr Opin Gastroenterol2007. 23 (4):452\u2013455."},{"issue":"4","key":"i0020-8868-96-2-95-Csendes5","series-title":"J Gastrointest Surg","first-page":"434","article-title":"Adenocarcinoma appearing very late after antireflux surgery for Barrett's esophagus: long term follow-up, review of the literature and addition of six patients.","volume":"8","author":"Csendes, A","year":"2004","unstructured":"Csendes, A, BurdilesP, BraghettoI, and KornO. Adenocarcinoma appearing very late after antireflux surgery for Barrett's esophagus: long term follow-up, review of the literature and addition of six patients.J Gastrointest Surg2004. 8 (4):434\u2013441."},{"issue":"1","key":"i0020-8868-96-2-95-Jamieson1","series-title":"Chest Surg Clin N Am","first-page":"149","article-title":"Results of laparoscopic antireflux operations in patients who have Barrett's esophagus.","volume":"12","author":"Jamieson, GG","year":"2002","unstructured":"Jamieson, GG, FranceM, and WatsonDI. Results of laparoscopic antireflux operations in patients who have Barrett's esophagus.Chest Surg Clin N Am2002. 12 (1):149\u2013155."},{"issue":"3","key":"i0020-8868-96-2-95-Jackson1","series-title":"Thorac Surg Clin","first-page":"429","article-title":"Surgical therapy for Barrett's esophagus.","volume":"15","author":"Jackson, CC","year":"2005","unstructured":"Jackson, CC and DeMeesterSR. Surgical therapy for Barrett's esophagus.Thorac Surg Clin2005. 15 (3):429\u2013436."},{"issue":"3","key":"i0020-8868-96-2-95-Mabrut1","series-title":"Ann Chir","first-page":"177","article-title":"[Barrett's esophagus: place of antireflux surgery].","volume":"131","author":"Mabrut, JY","year":"2006","unstructured":"Mabrut, JY and BaulieuxJ. [Barrett's esophagus: place of antireflux surgery].Ann Chir2006. 131 (3):177\u2013182."},{"issue":"4","key":"i0020-8868-96-2-95-Csendes6","series-title":"J Gastroenterol Surg","first-page":"645","article-title":"Effect of duodenal diversion on low grade dysplasia in patients with Barrett's esophagus: analysis of 215 patients.","volume":"6","author":"Csendes, A","year":"2002","unstructured":"Csendes, A, SmokG, BurdilesP, BraghettoI, CastroC, and KornO. 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Surgical treatment of Barrett's esophagus: 1980\u20132003.World J Surg2004. 28 (3):225\u2013231."},{"issue":"1","key":"i0020-8868-96-2-95-Csendes8","series-title":"Surgery","first-page":"46","article-title":"Regression of intestinal metaplasia to cardiac or fundic mucosa in patients with Barrett's esophagus submitted to vagotomy, partial gastrectomy and duodenal diversion: a prospective study in 78 patients more than 5\u00a0years follow-up.","volume":"139","author":"Csendes, A","year":"2006","unstructured":"Csendes, A, BraghettoI, BurdilesP, SmokG, HenriquezA, and ParadaF. 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