Malattia esofagea nella Sclerosi Sistemica: opzioni terapeutiche medico-endoscopico-chirurgiche.

SUMMARY Systemic Sclerosis (SSc) is a disease of the connective tissue involving a large number of organs. Gastrointestinal tract can be involved in a more than 90% of cases. Esophageal lesions are present in 85-90%. Anatomically they consist in a progressive fibrosis and atrophy of the muscolaris propria. Motor disorders due to such lesions, very frequently cause a gastroesophageal reflux disease. Often patients with SSc suffer from severe GER and have an higher incidence of complication as peptic structures or Barrett Esophagus. Usually BE patients undergo antireflux surgery which provides a very strong protection against the reflux. But antireflux operation, especially the Nissen fundoplication can produce a postoperative dysphagia that can make the quality of life of the patients with SSc worse. For this reason, Authors believe that SSc patients with GERD complicated by BE could be the best candidate for an ablative treatment by Radiofrequency associated with a long lasting therapy with PPI. In fact, Radiofrequency, recently proposed, seems to be effective in order to obtain the complete ablation of the metaplastic epithelium and to prevent the development of the adenocarcinoma