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Columnar metaplasia in the esophageal remnant after esophagectomy: a systematic review

Lookup NU author(s): Dr Lorna Dunn, Dr Jonathan Shenfine, Professor Michael Griffin

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Abstract

Barrett's metaplasia is a well-recognized risk factor for esophageal adenocarcinoma. It is believed to develop in response to the injurious effects of gastroesophageal reflux. Following subtotal esophagectomy and reconstruction with a gastric conduit, many patients experience profound reflux into the remnant esophagus. Barrett's-like epithelium has been described in these patients, and they have been identified as a potential human model in which to study the early events in the development of metaplasia. This phenomenon also raises clinical concerns about the long-term fate of the esophageal remnant following surgery and the potential for further malignant change. This systematic review summarizes the literature on the prevalence and timing of Barrett's metaplasia occurring after esophagectomy, reviews the evidence regarding risk factors and malignant progression in such patients, and considers the implications for clinical practice.

Publication metadata

Author(s): Dunn LJ, Shenfine J, Griffin SM

Publication type: Review

Publication status: Published

Journal: Diseases of the Esophagus

Year: 2015

Volume: 28

Issue: 1

Pages: 32-41

Print publication date: 01/01/2015

Online publication date: 13/11/2013

Acceptance date: 01/01/1900

ISSN (print): 1120-8694

ISSN (electronic): 1442-2050

Publisher: WILEY-BLACKWELL

URL: http://dx.doi.org/10.1111/dote.12129

DOI: 10.1111/dote.12129

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