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Barrett's ulcer: a surgical disease?
W A Williamson1, F H Ellis, S P Gibb
1Department of Thoracic and Cardiovascular Surgery, Lahey Clinic Medical Center, Burlington, MA 01805.
The Journal of Thoracic and Cardiovascular Surgery
|January 11, 1992
Summary
Barrett's ulcers, a complication of Barrett's esophagus, often heal with aggressive medical therapy. Surgery is reserved for non-healing ulcers or complications like bleeding or perforation.
Area of Science:
- Gastroenterology
- Gastrointestinal Surgery
- Oncology
Background:
- Barrett's esophagus is a condition where the lining of the esophagus changes.
- Adenocarcinoma can develop in Barrett's esophagus.
- Barrett's ulcers are a known complication.
Purpose of the Study:
- To determine the prevalence of Barrett's ulcers in patients with Barrett's esophagus.
- To evaluate the efficacy of medical and surgical treatments for Barrett's ulcers.
Main Methods:
- Retrospective review of 285 patients with Barrett's esophagus treated between 1973 and 1990.
- Analysis of 30 patients diagnosed with Barrett's ulcers.
- Assessment of treatment outcomes including medical therapy (H2 antagonists, antacids, dietary changes) and surgical intervention.
Main Results:
- The prevalence of Barrett's ulcers was 14% (30 of 212 patients with benign Barrett's esophagus).
- Complete healing occurred in 85% (23 of 27) of patients treated medically within 2-14 months.
- Surgical intervention was successful in all four patients with non-healing ulcers or complications.
Conclusions:
- The majority of Barrett's ulcers heal with aggressive medical therapy.
- Surgical intervention is effective for refractory cases or complications.
- Close endoscopic surveillance is crucial for managing Barrett's esophagus and its complications.