Epidemiology The incidence of esophageal cancer has increased in recent decades, with an estimated 17,990 new cases in the United States in 2013. Histologically, in the United States esophageal adenocarcinoma is the fastest-growing subtype, surpassing the incidence of esophageal squamous…
Esophageal cancer accounts for 1% of new cancer diagnoses in the United States annually and 2.6% of cancer-related deaths. An estimated 0.5% of men and women will be diagnosed with esophageal cancer at some point during their lifetime. The two…
Compared with the general population, patients with Barrett esophagus (BE) have a higher risk of developing esophageal adenocarcinoma (EAC) with the risk increasing in those patients who develop dysplasia—low-grade dysplasia (LGD) or high-grade dysplasia (HGD). In the past, patients with…
The British surgeon Norman Barrett is famously credited for his early description of the lower esophagus lined by columnar epithelium. However, he himself did not claim to be the first to describe the condition that would later bear his name.…
Prevalence and Incidence of Barrett Esophagus Barrett esophagus (BE) is the disease in which the normal squamous lining of the distal esophagus is replaced by a metaplastic columnar cell epithelium (termed intestinal metaplasia [IM]) in response to chronic severe gastroesophageal…
Esophageal adenocarcinoma (EAC) is a highly lethal disease associated with a survival of less than 20% at 5 years. The American Cancer Society estimates that 16,940 new esophageal cancer cases will be diagnosed in the United States in 2017, the…
Crural repair and reduction of hiatal hernia (HH) are paramount to the success of an antireflux surgery. Case series from the early laparoscopic era (i.e., the 1990s) reported an unacceptably high recurrence rate of HHs. In addition, some patients were…
Normally, several centimeters of the distal esophagus and the gastroesophageal junction (GEJ) lie below the hiatus within the abdomen. When the GEJ, the fundus of the stomach, or both migrate into the chest above the hiatus, a hiatal hernia is…
Laparoscopic repair of a large hiatal hernia with a widened hiatus is challenging and objective hernia recurrence rates are high. In a recent randomized trial, the recurrence rate exceeded 50% at 5 years after laparoscopic paraesophageal hernia. Tension on the…
Hiatal hernia (HH) was first recognized more than 400 years ago. In 1610 Ambrose Paré described a patient with the stomach herniating through the esophageal hiatus. Bowditch was the first to report repair of an HH in 1853, and Akerlund…