Comparison between Antireflux Surgery and Antacids for Gastroegsophageal Reflux Disease in the Preven-tion of Esophageal Adenocarcinoma: a Systematic Review and Meta-analysis
ZHANG Yu-xian
ZHANG Ruo-xi
LIU Dian-gang
GAO Xiang
ZHANG Chao
WANG Zhong-gao
Abstract：Objective To compare the preventive effect of antireflux surgery and antacids in the treatment of gastroesophageal reflux disease ( GERD) on esophageal adenocarcinoma ( EAC) . Methods A computerized litera-ture search of multiple electronic databases was performed on PubMed, EMBASE, Cochrane Library, Web of sci-ence, Wanfang and CNKI database for related literature on drug and surgical treatment of GRED from an unbounded start date to 2017, using English terms such as esophagus, neoplasm, cancer, Barrett's esophagus, adenocarcinoma, fundoplication, antireflux surgery, Nissen, Gastroesophageal reflux disease, Proton pump inhibitors and Chinese e-quivalents. The inclusion and exclusion criteria were set up for quality evaluation, data extraction and bias assess-ment. Results Seven academic papers were included in the Meta-analysis, including three RCTs, four case-control studies with 78 703 cases, of which there were 11 398 cases who received antireflux surgery ( surgerical treatment group) and 67 305 cases who received drug treatment ( drug treatment group) . The results of the Meta-analysis showed that there was no difference in canceration rate between surgical treatment group and drug treatment group (RR＝1. 10, 95% CI:0. 81, 1. 49, P ＝0. 54). After the research of Ye were eliminated, and Meta-analysis showed that canceration rate in drug treatment group was higher than that in surgical treatment group ( RR＝0. 38, 95% CI:0. 15, 0. 97, P＝0. 04). Conclusion In terms of canceration rate in patients with GERD with or without BE, antireflux surgery is superior to drug treatment. However, RCTS with larger sample size and long-term follow-up data are needed to confirm the role of antireflux surgery in the prevention of EAC.
Keywords：Gastroesophageal refluxBarrett esophagusAntireflux surgeryMeta-analysis
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 106-110 )