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Complex approach in diagnostics and treatment of gastroesophageal reflux disease complicated by metaplasia of the esophagus

[Surgery]
Denis Mihajlovich Cherkasov; Mihail Cherkasov; Sabina Gadzhievna, Melikova; Andrey Vladimirovich Skuratov; Sergeevich Todorov Sergey; Yurij Mihajlovich Starcev;

The treatment results of 34 patients with GERD complicated by metaplasia of the esophageal mucosa were analyzed. According to the pathomorphological conclusion, 19 (55.9 %) had intestinal metaplasia, in 9 (26.5 %) founded gastric metaplasia, in the remaining 6 cases – low-grade dysplasia against the background of intestinal (4) and gastric (2) metaplasia. After provided diagnosis verification, conservative therapy and antireflux surgery, the patient underwent argon-plasma coagulation, depended from the maximum length of the circular segment of metaplasia. There were no complications, associated with argon-plasma coagulation procedures. In the long-term period, all patients showed regeneration of metaplasia
areas with healthy tissue. In observation during 6 years, there were no patient had a relapse of the disease. The basis for the successful treatment is an integrated approach, and the developed technique of argon-plasma coagulation, that allows to avoid the esophageal strictures and to achieve the regression of metaplasia of the esophageal mucosa.

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Keywords: gastroesophageal reflux disease, reflux esophagitis, metaplasia of esophagus, Barrett’s esophagus


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