Tu1212 Cross-Sectional Study of the Association Between Obesity and Barrett's Esophagus in a Japanese Population: A Hospital-Based Prospective Pilot Study

Abstract

healed following endoscopic treatment and 20 (19%) following surgical treatment. One patient died before healing. The effectiveness of endoscopic treatment was maximal during the 3 months following the diagnosis of fistula: 86% (38/44) of cases of healing were obtained following endoscopic management, 11% (5/44) following medical treatment alone and 2% (1/44) following surgical treatment. Between the 6th and the 12th month of treatment, 50 % of cases of healing were obtained following surgery and 50 % following endoscopy; after the 12th month, 60 % of cases of healing were obtained following surgery and 40% following endoscopy. 90 patients (86.5%) underwent a drainage procedure (surgical, endoscopic or percutaneous). A total of 157 covered stents were placed in 83 patients (79.8%). The other endoscopic techniques were: excision of the fistula (n=42, 40.4%), clips (n=40, 38.5%), glue application (n=32, 30.8%), plug placement (n=8, 7.7%). Three significant predictive factors of healing after endoscopic treatment were identified by multivariate analysis: A short interval between the diagnosis of the fistula and the first endoscopy (, 21 days) (p=0.007), small fistula size (p=0.01) and per-operative glue application on the staple line during the LSG procedure (p=0.047). Conclusion In this first retrospective multicenter study, endoscopic management appears to be effective for the treatment of staple line leaks, particularly if it is performed early following diagnosis. Interventional endoscopy should be the preferred treatment during the first 6 months, whereas surgical treatment should be favored subsequently. Ideally, additional prospective studies should be performed in order to confirm this result.