Universität zu Köln

Fuchs, H. F., Schmidt, H. M., Meissner, M., Brinkmann, S., Maus, M., Bludau, M., Schroeder, W., Hoelscher, A. H. and Leers, J. M. (2018). Endoscopic and histopathologic reflux-associated mucosal damage in the remnant esophagus following transthoracic esophagectomy for cancer-5-year long-term follow-up. Dis. Esophagus, 31 (1). CARY: OXFORD UNIV PRESS INC. ISSN 1442-2050

Full text not available from this repository.

Abstract

Gastroesophageal reflux is a common problem following esophagectomy and reconstruction with gastric interposition. Despite a routine prescription of proton pump inhibitors, reflux-associated mucosal damage in the remnant esophagus is frequently observed. Purpose of this study is to evaluate mucosal damage in the esophageal remnant during long-term follow-up and to compare the prevalence of this damage between the subgroups of esophageal squamous cell and adenocarcinoma. All patients undergoing transthoracic Ivor-Lewis esophagectomy were prospectively entered in our IRB approved database. All patients underwent a routine check-up program with yearly surveillance endoscopies following esophagectomy. Only patients with a complete follow-up were included into this study. Endoscopic and histopathologic mucosal changes of the remnant esophagus were analyzed in close intervals. A total of 50 patients met the inclusion criteria, consisting of 31 adenocarcinomas (AC) and 19 squamous cell carcinomas (SCC). Mucosal damage was already seen 1 year after surgery in 20 patients macroscopically (43%) and in 21 patients microscopically (45%). At 5-year follow-up the prevalence for macroscopic and microscopic damage was 55% and 60%, respectively. The prevalence of mucosal damage was higher in AC patients than in SCC patients (1y-FU: 51% [AC] vs. 28% [SCC]; 5y-FU: 68% [AC] vs. 35% [SCC], P < 0.05). Newly acquired Barrett's esophagus was seen in 10 patients (20%) with two of those patients (20%) showing histopathologic proof of neoplasia. This study shows a high prevalence of reflux-associated mucosal damage in the remnant esophagus one year out of surgery and only a moderate increase in prevalence in the following years. Mucosal damage was more frequently seen in AC patients and the occurrence of de-novo Barrett's esophagus and de-novo neoplasia was high. Endoscopic surveillance with targeted biopsies seems to be an indispensable tool to follow patients after esophagectomy appropriately.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Fuchs, H. F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, H. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Meissner, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Brinkmann, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Maus, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bludau, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, A. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Leers, J. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-204321
DOI:	10.1093/dote/dox115
Journal or Publication Title:	Dis. Esophagus
Volume:	31
Number:	1
Date:	2018
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1442-2050
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language QUALITY-OF-LIFE; BARRETTS-ESOPHAGUS; CANCER; METAPLASIA; ADENOCARCINOMA; DIAGNOSIS; STOMACH; IMPACT; TIME Multiple languages Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/20432