• Annals of surgery · Dec 2016

    Multicenter Study

    Prevalence of Barrett Esophagus in Adolescents and Young Adults With Esophageal Atresia.

    • Anne Schneider, Frédéric Gottrand, Marc Bellaiche, François Becmeur, Alain Lachaux, Laure Bridoux-Henno, Jean-Luc Michel, Christophe Faure, Paul Philippe, Yvan Vandenplas, Claire Dupont, Anne Breton, Jean Gaudin, Thierry Lamireau, Laurence Muyshont, Guillaume Podevin, Sheila Viola, Valérie Bertrand, Dominique Caldari, Stéphanie Colinet, Catherine Wanty, Erik Sauleau, Emmanuelle Leteurtre, and Laurent Michaud.
    • *Reference Center for Congenital and Malformative Esophageal Disorders, Hôpital Jeanne de Flandre, Lille†Department of Pediatric Surgery, CHU, Strasbourg, France‡Department of Pediatric Gastroenterology, Hôpital Robert Debré, Paris, France§Department of Pediatric Gastroenterology, HFME, Lyon, France¶Department of Pediatric Gastroenterology, CHU, Rennes, France||Department of Pediatric Surgery, CH Départemental Félix Guyon, Saint Denis-La Réunion, France**Department of Pediatric Gastroenterology, Hôpital Mère-Enfants Ste Justine, Montréal, Canada††Pediatric Surgical Service, Centre Hospitalier de Luxembourg, Luxembourg, Grand-Duché du Luxembourg‡‡Department of Pediatric Gastroenterology, AZ VUB, Bruxelles, Belgium§§Department of Pediatric Gastroenterology, CHU, Caen, France¶¶Department of Pediatric Gastroenterology, Hôpital des Enfants, Toulouse, France||||Department of Pediatric Surgery, CHU, Poitiers, France***Department of Pediatric Gastroenterology, Hôpital des Enfants, Bordeaux, France†††Department of Pediatric Gastroenterology, HUDERF, Bruxelles, Belgium‡‡‡Department of Pediatric Surgery, CHU, Angers, France§§§Department of Pediatric Gastroenterology, Hôpital Trousseau, Paris, France¶¶¶Department of Pediatrics, CH, Le Havre, France||||||Department of Pediatric Gastroenterology, HME CHU, Nantes, France****Department of Gastroenterology CHC, Liège, Belgium††††Department of Pediatric Gastroenterology and Hepatology, UCL, Cliniques Universitaires St Luc, Bruxelles, Belgium‡‡‡‡Public Health, Methods in Clinical Research Team, CHU, Strasbourg, France§§§§Centre Biologie Pathologie, Lille, France.
    • Ann. Surg. 2016 Dec 1; 264 (6): 1004-1008.

    ObjectiveTo study the prevalence of Barrett esophagus (BE) (gastric and/or intestinal metaplasia) in adolescents treated for esophageal atresia (EA).Summary Of Background DataEA patients are at high risk of BE.MethodsThis multicenter prospective study included EA patients aged 15 to 19 years. All eligible patients were proposed an upper endoscopy with multistaged esophageal biopsies under general anesthesia. Histological suspicion of metaplasia was confirmed centrally.ResultsOne hundred twenty patients [mean age, 16.5 years (±1.4)] were included; 70% had been treated for gastroesophageal reflux disease (GERD) during infancy. At evaluation, 8% were undernourished, 41% had received antireflux surgery, and 41% presented with GERD symptoms, although only 28% were receiving medical treatment. Esophagitis was found at endoscopy in 34% and confirmed at histology in 67%. BE was suspected after endoscopy in 37% and was confirmed by histology for 43% of patients (50 gastric and 1 intestinal metaplasia). No endoscopic or histological anomalies were found at the anastomosis site. BE was not significantly related to clinical symptoms. In multivariate analysis, BE was associated with EA without fistula (P = 0.03), previous multiple antireflux surgery (P = 0.04), esophageal dilation (P = 0.04), suspicion of BE at endoscopy (P < 0.001), and histological esophagitis (P = 0.02).ConclusionsPatients with EA are at high risk of persistent GERD and BE. The development of BE is related to GERD history. Long-term systematic follow-up of the esophageal mucosa including multistaged biopsies is required, even in asymptomatic patients. (NCT02495051).

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