The Durability of Endoscopic Therapy for Treatment of @entity355 , XXXX , and Mucosal Cancer After Nissen Fundoplication.

@entity5 @entity1 @entity1141 @entity355
INTRODUCTION: Radiofrequency ablation (RFA)    endoscopic resection (EMR) is an established treatment strategy for neoplastic @entity5 . Most @entity1 are managed with proton pump inhibitors. The incidence of recurrent @entity355 , @entity1141 , or @entity5 after complete eradication is up to 43  % using this strategy. We hypothesize the addition of fundoplication should result in a lower recurrence rates after complete eradication. METHODS: Multi-institutional retrospective review of @entity1 undergoing endotherapy followed by Nissen fundoplication RESULTS: A total of 49 @entity1 underwent RFA    EMR followed by Nissen fundoplication. Complete remission of intestinal metaplasia (CR-IM) was achieved in 26 (53  %) @entity1 , complete remission of @entity1141 (CR-D) in 16 (33  %) @entity1 , and 7 (14  %) had persistent neoplastic Barrett's. After fundoplication, 18/26 (70  %) remained in CR-IM. An additional 10/16 CR-D achieved CR-IM and 4/7 with persistent @entity1141 achieved CR-IM. One @entity1 progressed to LGD while no @entity1 developed HGD or @entity5 . CONCLUSION: Endoscopic therapy for @entity355 and/or intramucosal @entity5 followed by fundoplication results in similar durability of CR-IM to @entity1 being managed with PPIs alone after endoscopic therapy. However, fundoplication may be superior in preventing further progression of disease and the development of @entity5 . Fundoplication is an important strategy to achieve and maintain CR-IM, and facilitate eradication of persistent @entity1141 .
