Antireflux Surgery for Barrett's Esophagus: Where Do We Stand in Preventing Esophageal Adenocarcinoma?

Esophageal adenocarcinoma is a major global health concern, primarily arising from gastroesophageal reflux disease, with Barrett's esophagus being its main precursor. Although proton pump inhibitors are commonly used to manage the symptoms from gastroesophageal reflux disease, their role in preventing esophageal adenocarcinoma progression remains uncertain. The aim of this review is to summarize the current advances in the diagnosis of Barrett's esophagus and its progression, as well as to critically evaluate and compare the impact of antireflux surgery on Barrett's esophagus and its potential role in preventing its progression to esophageal adenocarcinoma. In conclusion, surgical intervention, particularly antireflux surgery, has been associated with reduced esophageal adenocarcinoma risk in some studies, offering better long-term symptom control and possibly preventing cancer progression. However, other authors suggest that the cancer risk does not decrease significantly with surgery, highlighting the need for further investigation into its long-term preventive benefits. Several novel strategies have been established over the last few years that will facilitate an early diagnosis of Barrett's esophagus in the future.