Surgery for Barrett’s esophagus shows a significant regression rate, particularly in shorter segments, influencing patient management.

• Histologic regression occurred in 53.4% of patients overall, with 68.9% in ultrashort and 51.2% in short segments, but 0% in long-segment Barrett’s (p<0.001).
• Key predictors of regression included an anatomically intact repair (64.2% vs. 38.8% for disrupted, p<0.001) and the absence of severe esophagitis (OR 3.31, p=0.002).

Understanding these predictors can guide surveillance strategies and surgical decision-making for Barrett’s patients.

• Patients with no regression often presented with larger hiatal hernias and more severe reflux symptoms.