Acid Reflux Surgery
Acid Reflux Surgery for Barrett’s Esophagus
If GERD is not controlled by lifestyle changes and diet modifications, acid reflux disease could lead to Barrett’s esophagus.
Due to the ongoing invasion of digestive fluids in the lower esophagus, the body might attempt a system of damage control that could lead to the onset of cancer.
In this process, normal cells are replaced with precancerous abnormal cells resembling those of the stomach and intestinal lining.
This results in a condition called “dysplasia”.
If left untreated, high-grade dysplasia, or “carcinoma in situe” could eventually lead to a deadly form of cancer.
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Esophagectomy
This surgical procedure for Barrett's esophagus is the removal of all or part of the lower esophagus infected with high-grade dysplasia or cancerous cells.
This is usually performed with laparoscopic and thorascopic instruments and is fairly invasive.
Many people with Barrett’s esophagus are older and have other medical problems, so in these cases, it's unwise for them to undergo this surgery.
The procedure is also rather painful and recovery takes about a month, during which time the patient will have to maintain a largely liquid diet.
Endoscopic Surgery
Photodynamic Therapy (PDT)
In this acid reflux surgery, a light sensitive agent called "Photofrin" is injected intravenously followed by endoscopic laser treatment 48 hours later.
The laser activates the Photofrin and this destroys the high-grade dysplasia or cancerous tissue in the lower esophagus.
Complications include chest pain, nausea, esophageal strictures and sun sensitivity for several weeks following the procedure.
Endoscopic Mucosal Resection (EMR)
Before this surgery is carried out, ultrasound is done to ensure that the cancerous cells have not invaded past the basement membrane into tissue below the surface.
With this procedure, the infected esophageal lining is either lifted and a solution is injected under it, or suction is used to raise it prior to the lining being cut off.
Complications can include bleeding or tearing of the esophagus.
On occasions EMR is carried out in conjunction with PDT.
Until recently these surgical procedures have been fraught with complications, however, a safe new technique has since been developed:
Radiofrequency Ablation
In the writer's opinion this technique will soon replace many outdated surgical procedures.
RFA is a non-invasive procedure in which thermal energy is used to destroy cancerous or precancerous cells in the lower esophagus.
Both the HALO 360 and the HALO 90 are balloon based Radiofrequency devices that employ electrically charged heating coils to burn away abnormal cancerous and precancerous cells caused by dysplasia.
In a landmark clinical trial led by the University of North Carolina at Chapel Hill, results proved the almost total effectiveness of this new non-invasive acid reflux surgery.
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