Ann Surg: A long-term (18-year) prognostication of the LONG-term Barrett esother for AS-DD surgery!

Barrett's esophageal (BE) is a dangerous complication of chronic gastroesophageal reflow disease (GERD), characterized by normal squamous epithelat cells replaced by columnal mucosa (CLM) and intestinal epithelitis (IM) with cup cells, and is the only known precancer lesions of esophageal adenocarcinoma (EAC).
most non-obese BE patients are treated with Nissen gastric floor folding, however, Nissen gastric bottom folding has been shown not to stop the mixed reflow of Barrett's esother.
The prospective study aims to assess the long-term efficacy of acid suppression-duod intestinal severity (AS-DD) surgery (including selective ecstasy neuroresisting, gastric bottom folding, gastric excision plus Roux-en-Y reconstructive surgery) to treat long-term BE (LSBE) and ultra-long-segment BE (ELSBE) to determine the histological effects of AS-DD surgery on gastroenterology and progression to EAC.
127 subjects were recruited through the research process, including 102 for LSBE and 25 for ELSBE.
81 per cent of cases followed for an average of 18 years.
88% of the cases in the postoperative Visick-rated LSBE group were Visick-rated I-II, and 65% of the cases in the ELSBE group (P.lt;0.01).
esoitis and esohagic peptic ulcers healed significantly, and 71% of the stenosis disappeared.
38 per cent of IM cases in the LSBE group were transferred.
two cases in each of the two groups were EAC, which took an average of 15 years.
the cure rate of pathological gastric acid reflow was 91%, and the cure rate of 12-finger intestinal reflow was 100%.
80% of low-level heterogeneity recedes to IM.
before and after surgery, AS-DD can permanently eliminate pathological esothopathic reflow.
the risk of progression into HGD/EAC with AS-DD treatment was reduced by 8 times and ELSBE by 2.2 times compared to medical treatment.
AS-DD appears to affect IM behavior and is an effective treatment that can reduce and delay EAC progress.