The study by Åkerström et al1 recently published in Gastroenterology is an important one to add to the body of literature regarding the role of antireflux surgery (ARS) to decrease the risk of progression in Barrett’s esophagus (BE). The recent American College of Gastroenterology guideline on the diagnosis and management of BE suggests against the use of ARS as a measure to decrease the risk of progression, although this recommendation was conditional with a low level of evidence.2 One specific important factor that is missing from the data in the study by Åkerström et al1 is whether ARS was effective in eliminating or decreasing the burden of reflux.
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