1. Long-term outcome of microscopic esophagitis in chronic GERD patients treated with esomeprazole or laparoscopic antireflux surgery in the LOTUS trial
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Fiocca, R, Mastracci, L, Engström, C, Attwood, S, Ell, C, Galmiche, Jp, Hatlebakk, J, Junghard, O, Lind, T, Lundell, L, LOTUS trial collaborators, Including, Cestari, Renzo, Missale, Guido, Department of Anatomic Pathology, Universita degli studi di Genova, Department of Surgery, Sahlgrenska University Hospital [Gothenburg], North Tyneside Hospital, Department of Gastroenterology, Dr Horst Schmidt-Hospital, Department of Gastroenterology and Hepatology, Université de Nantes (UN), CIC 004, Institut National de la Santé et de la Recherche Médicale (INSERM), Department of Medicine, Haukeland University Hospital, University of Bergen (UiB)-University of Bergen (UiB), Astra Zeneca R & D, Karolinska University Hospital [Stockholm], LOTUS trial, Università degli studi di Genova = University of Genoa (UniGe), and Sinniger, Valérie
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Male ,Time Factors ,Fundoplication ,Kaplan-Meier Estimate ,MESH: Risk Assessment ,Gastroenterology ,Severity of Illness Index ,Esomeprazole ,0302 clinical medicine ,MESH: Incidence ,MESH: Treatment Outcome ,MESH: Statistics, Nonparametric ,MESH: Middle Aged ,Incidence ,Biopsy, Needle ,MESH: Sex Distribution ,food and beverages ,MESH: Follow-Up Studies ,Middle Aged ,Immunohistochemistry ,MESH: Esophagoscopy ,humanities ,3. Good health ,Treatment Outcome ,030220 oncology & carcinogenesis ,MESH: Fundoplication ,Gastroesophageal Reflux ,030211 gastroenterology & hepatology ,Female ,Esophagoscopy ,Omeprazole ,medicine.drug ,Adult ,medicine.medical_specialty ,MESH: Biopsy, Needle ,Esophageal pH Monitoring ,MESH: Probability ,MESH: Omeprazole ,Risk Assessment ,Statistics, Nonparametric ,03 medical and health sciences ,Age Distribution ,Internal medicine ,MESH: Severity of Illness Index ,otorhinolaryngologic diseases ,medicine ,Humans ,Sex Distribution ,Esophagitis, Peptic ,MESH: Age Distribution ,MESH: Kaplan-Meier Estimate ,Probability ,Antireflux surgery ,microscopic esophagitis ,MESH: Humans ,Hepatology ,business.industry ,MESH: Chronic Disease ,MESH: Esophageal pH Monitoring ,fungi ,MESH: Time Factors ,MESH: Esophagitis, Peptic ,MESH: Adult ,MESH: Immunohistochemistry ,[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,medicine.disease ,[SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,digestive system diseases ,MESH: Male ,Surgery ,MESH: Gastroesophageal Reflux ,Chronic Disease ,GERD ,business ,Esophagitis ,MESH: Female ,Follow-Up Studies - Abstract
International audience; OBJECTIVES: Gastroesophageal reflux disease (GERD)-associated changes in esophageal histology have been reported mainly after short-term medical antireflux therapy, and few individual lesions have been examined. We report detailed histological findings from the LOTUS study, at baseline and at 1 and 3 years after laparoscopic antireflux surgery (LARS) or esomeprazole treatment in patients with chronic GERD. METHODS: LOTUS is a long-term, open, parallel-group, multicenter, randomized, controlled trial conducted in 11 European countries that compared LARS (n=248) with esomeprazole 20-40 mg daily (n=266). Biopsies from the distal esophagus 2 cm above the Z-line and at the Z-line were taken at baseline, and 1 and 3 years. The following lesions were assessed: basal cell hyperplasia (BCH), papillary elongation (PE), intercellular space dilatations (ISDs), intraepithelial eosinophils (EOSs), neutrophils, and necrosis/erosion. A severity score (SS, range 0-2) was calculated by taking the average score of all assessable lesions. RESULTS: All lesions were more severe on Z-line biopsies than at 2 cm, and almost all improved significantly from baseline to 1 and 3 years. The average SS (from 2 cm to Z-line) changed from 0.95 to 0.57 (1 year) and to 0.49 (3 years) on esomeprazole, and from 0.91 to 0.56 (1 year) and to 0.52 (3 years) after LARS (P
- Published
- 2010
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