Regression of Columnar Esophageal (Barrett's) Epithelium after Anti-Reflux Surgery

Abstract

Columnar esophageal (Barrett's) epithelium is thought to be a reparative or metaplastic response to gastroesophageal reflux.^{1 2 3} This epithelium has been associated with dysplasia and adenocarcinoma in situ^{4 , 5} and with frank adenocarcinoma.^{6 , 7} There is evidence in individual patients that prolonged severe reflux leads to orad progression of the columnar epithelium,^{1 , 8} but the effect of surgical correction of reflux on the epithelium is less certain. Two studies suggest that columnar epithelium tends to persist after anti-reflux surgery.^{9 , 10} We obtained multiple localized suction-biopsy specimens from 10 patients in whom reflux had been surgically treated and preoperative studies had revealed columnar epithelium. The reflux . . .