Esófago de Barrett y su manejo
Palabras clave:
esófago de Barrett, adenocarcinoma, cirugía antirreflujoResumen
Se hace un recuento histórico del esófago de Barrett desde su descripción por Norman Barrett en 1950. Se discute la evolución del concepto. Se definen el esófago de Barrett corto y largo, su prevalencia y diagnóstico. Con respecto a su tratamiento, se propone tener en cuenta la opinión de DeMeester y DeMeester que identifican tres objetivos en los pacientes que presentan esta enfermedad: controlar el reflujo; promover o inducir curación o regresión del epitelio metaplásico de tal manera que sea eliminada la mucosa en riesgo (metaplasia intestinal), y detener la progresión a displasia y cáncer. Se discuten los manejos médico y quirúrgico y, en especial, las ventajas de este último. Se expone la pertinencia del adenocarcinoma y las displasias de bajo y alto grado en relación con el esófago de Barrett.
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Referencias bibliográficas
1. DEMEESTER STEVEN, DEMEESTER TOM. Columnar mucosa and intestinal metaplasia of the esophagus. Fifty years of controversy. Ann Surg 2000; 231: 303-321.
2. BARRETT M. The lower esophagus lined by columnar epithelium. Surgery 1957; 41: 881-894.
3. PAULL A, TRIER JS, DALTON MD, CAMP RC, LOEB P, GOYAL RK. The histologic spectrum of Barrett esophagus. N Eng J Med 1976; 295: 476-480.
4. SAMPLINER RE. Practice guidelines on the diagnosis, surveillance, and therapy of Barrett’s esophagus. The Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1998; 93: 1028-1032.
5. PHILLIPS RW, WONG RK. Barrett´s esophagus. Natural history, incidence, etiology, and complications (review). Gastroenterol Clin North Am 1991; 20: 791-816.
6. CAMERON AJ. Epidemiology of columnar-lined esophagus and adenocarcinoma (review). Gastroenterol Clin North Am 1997; 26: 487-494.
7. MELGUIZO BERMÚDEZ M. Esófago de Barrett y cirugía antirreflujo. Rev Colomb Cir 2001: 16: 180-184.
8. CAMERON AJ, ZINSMEISTER AR, BALLARD DJ, et al. Prevalence of columnar –lined (Barrett´s) esophagus. Comparison of population-based clinical and autopsy findings. Gastroenterology 1990; 99: 918-922.
9. BREMNER CG, BREMNER RM. Barrett´s esophagus. 1997; 77: 115-1137.
10. CAMERON AJ, OTT BJ, PAYNE WS. The incidence of adenocarcinoma in columnar-lined (Barrett´s) esophagus. N Engl J Med 1985; 313: 857-859.
11. REID BJ. Barrett´s Esophagus and esophageal adenocarcinoma. Gastroenterol Clin North Am 1991; 20: 817-833.
12. PATIÑO JF. Esófago de Barrett. Rev Colomb Cir 2002; 17: 37-65.
13. STEIN HJ, KAUER WKH, FEUSSNER H, et al. Bile reflux in benign and malignant Barrett’s esophagus: effect of medical acid suppression and Nissen fundoplication. J Gastrointest Surg 1998; 2: 333-341.
14. ORTIZ A, MARTÍNEZ DE HARO LF, PARRILLA P, et al. Conservative treatment versus antireflux surgery in Barrett’s esophagus: longterm results of a prospective study. Br J Surg 1996; 83: 274-278. 6. Cameron AJ, Zinsmeister AR, Ballard DJ, et al. Prevalence of columnar –lined (Barrett´s) esophagus. Comparison of populationbased clinical and autopsy findings. Gastroenterology 1990; 99: 918-922.
15. SPECHLER SJ. Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans. The Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group. N Engl J Med 1992; 326: 786-792.
16. HORGAN S, PELLEGRINI CA. Surgical treatment of gastroesophageal reflux disease. Surg Clin North Am 1997; 77: 1063-1087.
17. HUNTER JG, TRUS TL, BRANUM GD, et al. A physiologic approach to laparoscopic fundoplication for gastroesophageal reflux disease. Ann Surg 1996; 223: 673-687.
18. RICHARDSON WS, TRUS TL, HUNTER JG. Laparoscopic antireflux surgery. Surg Clin North Am 1996; 76: 437-450.
19. MELGUIZO M. Cirugía antirreflujo por laparoscopia. Una serie de 100 pacientes. Rev Colomb Cir 2001; 16: 72-80.
20. ZUNDEL N, RESTREPO H, VÁSQUEZ J, TORO R. Cirugía antirreflujo por laparoscopia. Rev Colomb Cir 1997; 12: 267-271.
21. URIBE AL, MORALES CH, RAMÍREZ N, VALENCIA JT. Tratamiento laparoscópico de la enfermedad por reflujo gastroesofágico. Rev Colomb Cir 1999; 14: 224-230.
22. ARANGO LA, ÁNGEL P. Reflujo gastroesofágico. Conceptos actuales, evaluación y presentación de 50 enfermos intervenidos laparoscópicamente con seguimiento de 6 meses. Rev Colomb Cir 1997; 12: 251-263.
23. WETSCHER GJ, GLASER K, WIESCHEMEYER T, et al. Cisapride enhances the effect of partial posterior fundoplication on esophageal peristalsis in GERD patients with poor esophageal contractility. Dig Dis Sci 1998; 43: 1986-1990.
24. HINDER RA, FILIPI CJ, WETSCHER G, et al. Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease. Ann Surg 1994; 220: 472-483.
25. DEMEESTER SR. History of Barrett’s esophagus and definition of terms. Prob Gen Surg 2001; 18: 1-3.
26. JAMIESON GG, FRANCE M, WATSON DI. Results of laparoscopic antireflux operations in patients who have Barrett’s esophagus. Chest Surg Clin North Am 2002; 12: 149-155.
27. PARRILLA P, MARTÍNEZ DE HARO LF, ORTIZ A, MUNITIZ V. Standard antireflux operations in patients who have Barrett’s esophagus. Current results. Chest Surg Clin N Am 2002; 12: 113-126.
28. DEMEESTER SR, PETERS JH, DEMEESTER TR. Barrett’s esophagus. Curr Probl Surg 2001; 38: 553.
29. MCCALLUM R, POLEPALLE S, DAVENPORT K, FRIERSON H, BOYD S. Role of antireflux surgery against dysplasia in Barrett’s esophagus. Gastroenterology 1991; 100: A12.
30. KATZ D, ROTHSTEIN R, SCHNED A, DUNN J, SEAVER K, ANTONIOLI D. The development of dysplasia and adenocarcinoma during endoscopic surveillance of Barrett’s esophagus. Am J Gastroenterol 1998; 93: 536-541.
31. HOFSTETTER W, PETERS J, DEMEESTER TM, HAGEN JA, DEMEESTER SR, et al. Long-Term outcome of antireflux surgery in patients with barrett’s esophagus. Ann Surg 2001; 234: 532-539.
32. WETSCHER GJ, GADENSTAETTER M, KLINGER PJ, et al. Efficacy of medical therapy and antireflux surgery to prevent Barrett’s metaplasia in patients with gastroesophageal reflux disease. Ann Surg 2001; 234: 627-632.
33. WETSCHER GJ, GLASER K, GADENSTAETTER M, et al. The effect of medical therapy and antireflux surgery on dysphagia in patients with gastroesophageal reflux disease (GERD) without esophageal stricture. Am J Surg 1999; 177: 189-192.
34. HINDER RA, STEIN HJ, BREMNER CG, et al. Relationship of a satisfactory outcome to normalization of delayed gastric empting after Nissen fundoplication. Ann Surg 1989; 210: 458-465.
35. FARRELL TM, ARCHER SB, GALLOWAY KD, et al. Heatburn is more likely to recur after Toupet fundoplication than Nissen fundoplication. Ann Surg 2000; 66: 229-237.
36. JOBE B, WALLACE J, HANSEN P, SWANSTROM L. Evaluation of laparoscopic Toupet fundoplication as a primary repair for all patients with medically resistant gastroesophageal reflux. Surg Endosc 1997; 11: 1089-1093.
37. TYTGAT GNJ. Endoscopic features of the columnar-lined esophagus. Gastroenterol Clin North Am 1997; 26: 507-517.
38. PROVENZALE D, KEMP JA, ARORA S, WONG JB. A guide for surveillance of patients with Barrett´s esophagus. Am J Gastroenterol 1994; 89: 670-680.
39. BOSCHER L, TAYLOR F. Heterotopic gastric mucosa in the esophagus with ulceration and stricture formation. J Thorac Cardiovasc Surg 1951; 21: 306-312.
40. JASS JR. Mucin histochemistry of the columnar epithelium of the esophagus: a retrospective study. J Clin Pathol 1981; 34: 866-870.
41. TORRADO J, CORREA P, RUIZ B, BERNARDI P, ZAVALA D, BARA J. Lewis antigen alterations in gastric cancer precursors. Gastroenterology 1992; 102: 424-430.
42. TORRADO J, CORREA P, RUIZ B, BERNARDI P, ZAVALA D, BARA J. Lewis antigen alterations in gastric cancer precursors. Gastroenterology 1992; 102: 424-30.
43. LEVINE D, HAGGITT R, IRVINE S, REID B. Natural history of highgrade dysplasia in Barrett’s esophagus. Gastroenterology 1996; 110: A550.
44. SCHNELL T, SONTAG S, CHEJFEC G, et al. High-grade dysplasia (HGD) is not an indication for surgery in patients with Barrett’s esophagus. Gastroenterology 1996; 110: A590.
45. PETERS JH, CLARK GW, IRELAND AP, CHANDRASOMA P, SMYRK TC, DEMEESTER TR. Outcome of adenocarcinoma arising in Barrett’s esophagus in endoscopically surveyed and nonsurveyed patients. J Thorac Cardiovasc Surg 1994; 108: 813-822.
46. FERGUSON MK, NAUNHEIM KS. Resection for Barrett’s mucosa with high-grade dysplasia: implications for prophylactic photodynamic therapy. J Thorac Cardiovasc Surg 1997; 114: 824-829.
47. CAMERON AJ, CARPENTER HA. Barrett’s esophagus, high-grade dysplasia, and early adenocarcinoma: a pathological study. Am J Gastroenterol 1997; 92: 586-591.
48. NIGRO JJ, HAGEN JA, DEMEESTER TR, et al. Prevalence and location of nodal metastases in distal esophageal adenocarcinoma confined to the wall: implications for therapy. J Thorac Cardiovasc Surg 1999; 117: 16-25.
49. GARCÍA A, VINAGRERAS J. TACATIC B. Terapia de ablación en pacientes con esófago de Barrett utilizando electrocoagulación con argón plasma: experiencia preliminar en el Hospital Español de México. Endoscopia 1999; 10: 151-154.
50. BREMNER RM, BREMNER CG. Ablation therapy for Barrett’s esophagus. Prob Gen Surg 2001; 18: 85-93.
51. OVERHOLT BF, PANJEHPOUR M, HAYDECK JM. Photodynamic therapy for Barrett’s esophagus: follow-up in 100 patients. Gastrointest Endosc 1999; 49: 1-7.
52. BREMNER RM, MASON RJ, BREMNER CG et al. Ultrasonic intraluminal ablation of esophageal mucosa: a new technique for Barrett´s ablation. Surg Endosc 1998; 12: 342-347.
53. HAGEN JA. Treatment of Barrett’s with dysplasia: low grade and high grade. Prob Gen Surg 2001; 18: 99-107.
54. REY M. Aplicación de nuevos abordajes en el tratamiento de lesiones malignas y premalignas en esófago, estómago, colon y recto. Rev Colomb Cir 2001; 16: 127-136.
55. NIGRO JJ, HAGEN JA, DEMEESTER TR, et al. Occult esophageal adenocarcinoma: extent of disease and implications for effective therapy. Ann Surg 1999; 230: 433-440.
56. DE PAULA AL, HASHIBA K, FERREIRA EB, et al. Laparoscopic transhiatal esophagectomy. Surg Lap Endosc 1995; 5: 1-5.
57. COLLARD JM. High-grade dysplasia in Barrett’s esophagus. Chest Surg Clin N Am 2002; 12: 77-92.
58. REID BJ, HAGGIST RC, RUBIN CE, et al. Observer variation in the diagnosis of dysplasia in Barrett’s esophagus. Hum Pathol 1988; 19: 166-178.
59. SKACEL M, PETRAS RE, GRAMLICH TL, SIGEL JE, RICHTER JE, GOLDBLUM JR. The diagnosis of low-grade dysplasia in Barrett’s esophagus and its implications for disease progression. Am J Gastroenterol 2000; 95: 3383-3387.
60. MONTGOMERY E, BRONNER MP, GOLDBLUM JR, et al. Reproducibility of the diagnosis of dysplasia in Barrett’s esophagus: a reaffirmation. Hum Pathol 2001; 32: 368-378.
61. SPECHLER SJ. Barrett’s esophagus. N Eng J Med 2002; 346: 836-842.
62. DEMEESTER SR, CAMPOS GM, DEMEESTER TR, et al. The impact of an antireflux procedure on intestinal metaplasia of the cardia. Ann Surg 1998; 228: 547-556.
63. LOW DE, LEVINE DS, DAIL DH, KOSAREK RA. Histological and anatomic changes in Barrett’s esophagus after antireflux surgery. Am J Gastroenterol 1999; 94: 80-85.
2. BARRETT M. The lower esophagus lined by columnar epithelium. Surgery 1957; 41: 881-894.
3. PAULL A, TRIER JS, DALTON MD, CAMP RC, LOEB P, GOYAL RK. The histologic spectrum of Barrett esophagus. N Eng J Med 1976; 295: 476-480.
4. SAMPLINER RE. Practice guidelines on the diagnosis, surveillance, and therapy of Barrett’s esophagus. The Practice Parameters Committee of the American College of Gastroenterology. Am J Gastroenterol 1998; 93: 1028-1032.
5. PHILLIPS RW, WONG RK. Barrett´s esophagus. Natural history, incidence, etiology, and complications (review). Gastroenterol Clin North Am 1991; 20: 791-816.
6. CAMERON AJ. Epidemiology of columnar-lined esophagus and adenocarcinoma (review). Gastroenterol Clin North Am 1997; 26: 487-494.
7. MELGUIZO BERMÚDEZ M. Esófago de Barrett y cirugía antirreflujo. Rev Colomb Cir 2001: 16: 180-184.
8. CAMERON AJ, ZINSMEISTER AR, BALLARD DJ, et al. Prevalence of columnar –lined (Barrett´s) esophagus. Comparison of population-based clinical and autopsy findings. Gastroenterology 1990; 99: 918-922.
9. BREMNER CG, BREMNER RM. Barrett´s esophagus. 1997; 77: 115-1137.
10. CAMERON AJ, OTT BJ, PAYNE WS. The incidence of adenocarcinoma in columnar-lined (Barrett´s) esophagus. N Engl J Med 1985; 313: 857-859.
11. REID BJ. Barrett´s Esophagus and esophageal adenocarcinoma. Gastroenterol Clin North Am 1991; 20: 817-833.
12. PATIÑO JF. Esófago de Barrett. Rev Colomb Cir 2002; 17: 37-65.
13. STEIN HJ, KAUER WKH, FEUSSNER H, et al. Bile reflux in benign and malignant Barrett’s esophagus: effect of medical acid suppression and Nissen fundoplication. J Gastrointest Surg 1998; 2: 333-341.
14. ORTIZ A, MARTÍNEZ DE HARO LF, PARRILLA P, et al. Conservative treatment versus antireflux surgery in Barrett’s esophagus: longterm results of a prospective study. Br J Surg 1996; 83: 274-278. 6. Cameron AJ, Zinsmeister AR, Ballard DJ, et al. Prevalence of columnar –lined (Barrett´s) esophagus. Comparison of populationbased clinical and autopsy findings. Gastroenterology 1990; 99: 918-922.
15. SPECHLER SJ. Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans. The Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group. N Engl J Med 1992; 326: 786-792.
16. HORGAN S, PELLEGRINI CA. Surgical treatment of gastroesophageal reflux disease. Surg Clin North Am 1997; 77: 1063-1087.
17. HUNTER JG, TRUS TL, BRANUM GD, et al. A physiologic approach to laparoscopic fundoplication for gastroesophageal reflux disease. Ann Surg 1996; 223: 673-687.
18. RICHARDSON WS, TRUS TL, HUNTER JG. Laparoscopic antireflux surgery. Surg Clin North Am 1996; 76: 437-450.
19. MELGUIZO M. Cirugía antirreflujo por laparoscopia. Una serie de 100 pacientes. Rev Colomb Cir 2001; 16: 72-80.
20. ZUNDEL N, RESTREPO H, VÁSQUEZ J, TORO R. Cirugía antirreflujo por laparoscopia. Rev Colomb Cir 1997; 12: 267-271.
21. URIBE AL, MORALES CH, RAMÍREZ N, VALENCIA JT. Tratamiento laparoscópico de la enfermedad por reflujo gastroesofágico. Rev Colomb Cir 1999; 14: 224-230.
22. ARANGO LA, ÁNGEL P. Reflujo gastroesofágico. Conceptos actuales, evaluación y presentación de 50 enfermos intervenidos laparoscópicamente con seguimiento de 6 meses. Rev Colomb Cir 1997; 12: 251-263.
23. WETSCHER GJ, GLASER K, WIESCHEMEYER T, et al. Cisapride enhances the effect of partial posterior fundoplication on esophageal peristalsis in GERD patients with poor esophageal contractility. Dig Dis Sci 1998; 43: 1986-1990.
24. HINDER RA, FILIPI CJ, WETSCHER G, et al. Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease. Ann Surg 1994; 220: 472-483.
25. DEMEESTER SR. History of Barrett’s esophagus and definition of terms. Prob Gen Surg 2001; 18: 1-3.
26. JAMIESON GG, FRANCE M, WATSON DI. Results of laparoscopic antireflux operations in patients who have Barrett’s esophagus. Chest Surg Clin North Am 2002; 12: 149-155.
27. PARRILLA P, MARTÍNEZ DE HARO LF, ORTIZ A, MUNITIZ V. Standard antireflux operations in patients who have Barrett’s esophagus. Current results. Chest Surg Clin N Am 2002; 12: 113-126.
28. DEMEESTER SR, PETERS JH, DEMEESTER TR. Barrett’s esophagus. Curr Probl Surg 2001; 38: 553.
29. MCCALLUM R, POLEPALLE S, DAVENPORT K, FRIERSON H, BOYD S. Role of antireflux surgery against dysplasia in Barrett’s esophagus. Gastroenterology 1991; 100: A12.
30. KATZ D, ROTHSTEIN R, SCHNED A, DUNN J, SEAVER K, ANTONIOLI D. The development of dysplasia and adenocarcinoma during endoscopic surveillance of Barrett’s esophagus. Am J Gastroenterol 1998; 93: 536-541.
31. HOFSTETTER W, PETERS J, DEMEESTER TM, HAGEN JA, DEMEESTER SR, et al. Long-Term outcome of antireflux surgery in patients with barrett’s esophagus. Ann Surg 2001; 234: 532-539.
32. WETSCHER GJ, GADENSTAETTER M, KLINGER PJ, et al. Efficacy of medical therapy and antireflux surgery to prevent Barrett’s metaplasia in patients with gastroesophageal reflux disease. Ann Surg 2001; 234: 627-632.
33. WETSCHER GJ, GLASER K, GADENSTAETTER M, et al. The effect of medical therapy and antireflux surgery on dysphagia in patients with gastroesophageal reflux disease (GERD) without esophageal stricture. Am J Surg 1999; 177: 189-192.
34. HINDER RA, STEIN HJ, BREMNER CG, et al. Relationship of a satisfactory outcome to normalization of delayed gastric empting after Nissen fundoplication. Ann Surg 1989; 210: 458-465.
35. FARRELL TM, ARCHER SB, GALLOWAY KD, et al. Heatburn is more likely to recur after Toupet fundoplication than Nissen fundoplication. Ann Surg 2000; 66: 229-237.
36. JOBE B, WALLACE J, HANSEN P, SWANSTROM L. Evaluation of laparoscopic Toupet fundoplication as a primary repair for all patients with medically resistant gastroesophageal reflux. Surg Endosc 1997; 11: 1089-1093.
37. TYTGAT GNJ. Endoscopic features of the columnar-lined esophagus. Gastroenterol Clin North Am 1997; 26: 507-517.
38. PROVENZALE D, KEMP JA, ARORA S, WONG JB. A guide for surveillance of patients with Barrett´s esophagus. Am J Gastroenterol 1994; 89: 670-680.
39. BOSCHER L, TAYLOR F. Heterotopic gastric mucosa in the esophagus with ulceration and stricture formation. J Thorac Cardiovasc Surg 1951; 21: 306-312.
40. JASS JR. Mucin histochemistry of the columnar epithelium of the esophagus: a retrospective study. J Clin Pathol 1981; 34: 866-870.
41. TORRADO J, CORREA P, RUIZ B, BERNARDI P, ZAVALA D, BARA J. Lewis antigen alterations in gastric cancer precursors. Gastroenterology 1992; 102: 424-430.
42. TORRADO J, CORREA P, RUIZ B, BERNARDI P, ZAVALA D, BARA J. Lewis antigen alterations in gastric cancer precursors. Gastroenterology 1992; 102: 424-30.
43. LEVINE D, HAGGITT R, IRVINE S, REID B. Natural history of highgrade dysplasia in Barrett’s esophagus. Gastroenterology 1996; 110: A550.
44. SCHNELL T, SONTAG S, CHEJFEC G, et al. High-grade dysplasia (HGD) is not an indication for surgery in patients with Barrett’s esophagus. Gastroenterology 1996; 110: A590.
45. PETERS JH, CLARK GW, IRELAND AP, CHANDRASOMA P, SMYRK TC, DEMEESTER TR. Outcome of adenocarcinoma arising in Barrett’s esophagus in endoscopically surveyed and nonsurveyed patients. J Thorac Cardiovasc Surg 1994; 108: 813-822.
46. FERGUSON MK, NAUNHEIM KS. Resection for Barrett’s mucosa with high-grade dysplasia: implications for prophylactic photodynamic therapy. J Thorac Cardiovasc Surg 1997; 114: 824-829.
47. CAMERON AJ, CARPENTER HA. Barrett’s esophagus, high-grade dysplasia, and early adenocarcinoma: a pathological study. Am J Gastroenterol 1997; 92: 586-591.
48. NIGRO JJ, HAGEN JA, DEMEESTER TR, et al. Prevalence and location of nodal metastases in distal esophageal adenocarcinoma confined to the wall: implications for therapy. J Thorac Cardiovasc Surg 1999; 117: 16-25.
49. GARCÍA A, VINAGRERAS J. TACATIC B. Terapia de ablación en pacientes con esófago de Barrett utilizando electrocoagulación con argón plasma: experiencia preliminar en el Hospital Español de México. Endoscopia 1999; 10: 151-154.
50. BREMNER RM, BREMNER CG. Ablation therapy for Barrett’s esophagus. Prob Gen Surg 2001; 18: 85-93.
51. OVERHOLT BF, PANJEHPOUR M, HAYDECK JM. Photodynamic therapy for Barrett’s esophagus: follow-up in 100 patients. Gastrointest Endosc 1999; 49: 1-7.
52. BREMNER RM, MASON RJ, BREMNER CG et al. Ultrasonic intraluminal ablation of esophageal mucosa: a new technique for Barrett´s ablation. Surg Endosc 1998; 12: 342-347.
53. HAGEN JA. Treatment of Barrett’s with dysplasia: low grade and high grade. Prob Gen Surg 2001; 18: 99-107.
54. REY M. Aplicación de nuevos abordajes en el tratamiento de lesiones malignas y premalignas en esófago, estómago, colon y recto. Rev Colomb Cir 2001; 16: 127-136.
55. NIGRO JJ, HAGEN JA, DEMEESTER TR, et al. Occult esophageal adenocarcinoma: extent of disease and implications for effective therapy. Ann Surg 1999; 230: 433-440.
56. DE PAULA AL, HASHIBA K, FERREIRA EB, et al. Laparoscopic transhiatal esophagectomy. Surg Lap Endosc 1995; 5: 1-5.
57. COLLARD JM. High-grade dysplasia in Barrett’s esophagus. Chest Surg Clin N Am 2002; 12: 77-92.
58. REID BJ, HAGGIST RC, RUBIN CE, et al. Observer variation in the diagnosis of dysplasia in Barrett’s esophagus. Hum Pathol 1988; 19: 166-178.
59. SKACEL M, PETRAS RE, GRAMLICH TL, SIGEL JE, RICHTER JE, GOLDBLUM JR. The diagnosis of low-grade dysplasia in Barrett’s esophagus and its implications for disease progression. Am J Gastroenterol 2000; 95: 3383-3387.
60. MONTGOMERY E, BRONNER MP, GOLDBLUM JR, et al. Reproducibility of the diagnosis of dysplasia in Barrett’s esophagus: a reaffirmation. Hum Pathol 2001; 32: 368-378.
61. SPECHLER SJ. Barrett’s esophagus. N Eng J Med 2002; 346: 836-842.
62. DEMEESTER SR, CAMPOS GM, DEMEESTER TR, et al. The impact of an antireflux procedure on intestinal metaplasia of the cardia. Ann Surg 1998; 228: 547-556.
63. LOW DE, LEVINE DS, DAIL DH, KOSAREK RA. Histological and anatomic changes in Barrett’s esophagus after antireflux surgery. Am J Gastroenterol 1999; 94: 80-85.
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2005-12-20
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Melguizo Bermúdez, M. Esófago De Barrett Y Su Manejo. Rev Colomb Cir 2005, 20, 203-209.
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