Primary Motility  Disorders of the  Esophagus
 The Esophageal
 Esophagogastric  Junction

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Volume: Barrett's Esophagus
Chapter: Treatments


Medical treatments

Acid suppression in Barrett’s esophagus: why and how?
C. Scarpignato, I. Pelosini, E. Molina  

What should be the minimal dosage and duration of treatment by proton pump inhibitors?
E.C. Klinkenberg-Knol  

Should non-steroidal antiinflammatory drugs be used for reversal of Barrett’s esophagus?
G. Morgan  Full article 
R.F. Souza  Full article 

What are the effects of therapy on length of Barrett’s epithelium?
K.R. DeVault  

How can length of Barrett’s epithelium be measured?
J.L. Barnett  

What are the effects of medical therapy on parietal cells? What are the consequences when medical treatment is stopped?
G. Tougas, R.H. Riddell, D.K Driman  

Is development of gastric polyps during proton pump inhibitor therapy related to the length of treatment?
B.E. Schenk, A. Cats, E.J. Kuipers  

Can any correlation betweeen gastric polyps development and dysplasia be anticipated in Barrett’s patients?
A.C. Svoboda, S. Tillisch-Svoboda, P.L. Morris  

Can intermittent therapy be envisaged in Barrett’s esophagus?
S. Bank, P. Singh, A.C. Yao  

What is the value of beta-carotene therapy in the treatment of Barrett’s esophagus?
L.F. Johnson  

Can promotility agents maintain remission in Barrett’s esophagus?
J.E. Richter  

Can dysplastic mucosa develop under treatment?
E.C. Klinkenberg-Knol  

How should maintenance treatment be conducted?
B.T. Cooper  

Following all these questions, shouldn’t the interest of prokinetics be strongly emphasized in the medical treatment of Barrett’s esophagus?
D.O. Castell  

Surgical treatments

How long should medical treatment be continued before antireflux surgery?
H. Koop  

Can specific indications for mid (Toupet) fundoplication be defined?
M.K. Schilling, M.W. Büchler  

Compared to the Nissen valve, what is the effect of partial posterior fundoplication on gastric emptying?
T. Perniceni  

What are the indications for an intrathoracic Nissen fundoplication? What are the drawbacks of this technique?
C. Gutschow, R. Romagnoli, J.-M. Collard  

Is a floppy valve a good guarantee against postoperative dysphagia?
D.I. Watson  

What are the indications for a Collis gastroplasty in Barrett’s patients?
L.L Swanstrom  

What are the differences between the Watson and Lortat-Jacob antireflux procedures?
A. Watson  

What is the current rate of gas-bloat syndrom following open and laparoscopic antireflux surgery?
M.I. Booth, T.C.B. Dehn  

Is gas-bloat syndrome likely to occur after medical therapy?
S.J. Spechler  

Should highly selective vagotomy be added to antireflux surgery?
H.J. Stein, W.K.H. Kauer, J.R. Siewert  

Emergency surgery in Barrett’s disease
J. Danis  

What are the drawbacks of vagotomy and antrectomy associated to total duodenal diversion and Roux-en-Y reconstruction?
V. Schumpelick, B. Dreuw, K. Ophoff, N. Ponschek, M. Niewiera  

What is the incidence of jejunal ulceration developed after Roux-en-Y gastrojejunostomy?
K.-H. Fuchs, S.M. Freys, M. Fein, H. Tigges  

What are the mechanisms for abnormal bacterial proliferation in the upper gastrointestinal tract?
V. Schumpelick, B. Dreuw, K. Ophoff, N. Ponschek, D. Schubert  

What are the consequences of duodenal hypomotility after total duodenal diversion and Roux-en-Y reconstruction?
V. Schumpelick, B. Dreuw, N. Ponschek, K. Ophoff, M. Niewiera  

What information can be expected from intraoperative manometry in the surgical treatment of gastroesophageal reflux disease?
J. Chipponi, K. Slim, D. Pezet  

What is the resent rate for conversion after laparoscopic approach?
I. Cecconello, C. Eduardo Domene, S. Szachnowicz, J. Gama-Rodrigues  

What are the indications for intraluminal suturing, Vicryl band ligation of the esophagus and submucosal teflon injection?
S.S. Kadirkamanathan, C.P. Swain  

Are mechanical complications higher after laparoscopic Nissen than after the open approach?
W.K.H. Kauer, H.J. Stein, J.R. Siewert  

What is the rate of occurrence of vagal damage after antireflux surgery?
M. Luostarinen  

What are the late results of laparoscopic antireflux surgery?
G. Zaninotto, D. Molena, M. Costantini, G. Portale, M. Costantino, B. Gnoccato, E. Ancona  

Can antireflux surgery be considered as potentially reducing the risk of malignancy?
B. Gayet  

How to interpret ostoperative progression of Barrett’s esophagus in asymptomatic patients with documented 24-hour pH studies?
I.G Martin  

What are the compared effects of medical strictures?
R.M. Bremner, C.G. Bremner  

Can any of these treatments avoid complications of Barrett’s disease?
E.C. Klinkenberg-Knol  

What is the current state of the trials comparing medical and surgical treatments in Barrett’s esophagus? The Spanish experience
P. Parrilla, A. Ortiz, L.F. Martínez de Haro, V. Munitiz  

The Italian experience
R. Ferraris, M. Morino and GOSPE (Gruppo Operativo per lo Studio delle Precancerosi Esofagee)  

Ablation therapy

What is the rofile of the best potential candidates for ablation therapy? The powerful influence of the hiatal hernia
S.J. Sontag  

What is the rate of squamous epithelialization following KTP laser ablation? What is the necessary length of treatment?
H. Barr  

What information can be drawn from available data regarding argon plasma coagulation for Barrett’s esophagus?
J.L. Barnett  

What are the indications of argon beam plasma coagulation for eradication of Barrett’s esophagus?
M. Kahaleh, J.-L. Van Laethem, J. Devičre  Full article 
C.D. Morris, J.P. Byrne, S.E.A. Attwood  Full article 

How should areas of ectopic gastric mucosa found in the upper esophagus be treated?
A. Sibille, D. Lacremans, N. Mahy, P. Warzée  

Compared to the hematoporphyrin derivatives, what are the advantages of the new photosensitizers?
J. Etienne, N. Dorme  

For the carrying out of the treatment, what are the advantages of spectrophorimetry?
B.F. Overholt  

What should be said today about the potential cardiac or pleural complications following hotodynamic therapy?
B.F. Overholt  

What are the effects of low dose photodynamic therapy (hematoporphyrin and argon dye laser) on healing of Barrett’s esophagus and stricture formation?
H. Barr  

Should the very variable thickness of Barrett’s epithelium be considered when evaluating the results of photodynamic therapy?
P. Chandrasoma, K. Wickramasinghe  

Is it unequivocally necessary to combine laser ablation with acid suppression?
R. Ackroyd  

Is it unequivocally necessary to combine laser ablation with antireflux surgery? What is the cost-benefit of separate or combined procedures?
E.I.T. Sihvo, J.A. Salo  

What are the various techniques of surgical endoscopic ablation?
T. Kawano, M. Endo  

What are the compared effects on esophageal layers of Cavi-pulse and other techniques for Barrett’s mucosal ablation? Is Cavi-pulse technique applicable to patients?
R.M. Bremner, C.G. Bremner, H.L. Valenta  

Are the results of endoscopic spray cryotherapy in animal experimentation in favor of mucosal ablation in Barrett’s patients?
M.H. Johnston  

What is the rate of esophageal stenoses observed after experimental ultrasonic ablation?
R.M. Bremner, D. Schwartz, C.G. Bremner  

With the use of centering balloons, should thermal ablation (Nd:YAG laser) be associated to hotodynamic therapy in long segments of Barrett’s mucosa?
M. Panjehpour  

Publication date: August 2003 OESO©2015