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dysphagia and fundoplications

Sabrina Rampado, Edoardo Savarino, Angelica Ganss, Giulia Pozza, Romeo Bardini
PURPOSE: The failure rate of laparoscopic anti-reflux surgery is approximately 10-20%. The aim of our prospective study was to investigate whether a modified Nissen fundoplication (MNF) can improve reflux symptoms and prevent surgical treatment failure in the midterm. METHODS: The MNF consisted of (1) suturing the esophagus to the diaphragmatic crura on each side using four non-absorbable stitches, (2) reinforcing clearly weak crura with a tailored Ultrapro mesh, and (3) fixing the upper stitch of the valve to the diaphragm...
March 17, 2018: Langenbeck's Archives of Surgery
Alberto Aiolfi, Emanuele Asti, Daniele Bernardi, Gianluca Bonitta, Emanuele Rausa, Stefano Siboni, Luigi Bonavina
BACKGROUND: Laparoscopic Nissen and Toupet fundoplication (LF) are currently considered gold-standard surgical treatment for Gastroesophageal Reflux Disease (GERD). Magnetic Sphincter Augmentation (MSA) is an innovative surgical procedure that has been showed to be effective to control GERD symptoms and to reduce esophageal acid exposure. The aim of this systematic review and meta-analysis was to compare early outcomes of LF and MSA. MATERIALS AND METHODS: PubMed, MEDLINE, Embase, and Cochrane databases were consulted matching the terms "Gastroesophageal reflux or heartburn", "LINX or magnetic sphincter augmentation" and "fundoplication"...
February 20, 2018: International Journal of Surgery
Petrus S S Castelijns, Marcel C G van de Poll, Johannes F Smulders
INTRODUCTION: Nissen fundoplication is frequently applied in the surgical treatment of patients with gastroesophageal reflux disease (GERD). When the gastroesophageal junction remains too large or becomes too narrow, persistent GERD or dysphagia may occur. To assure a correct size of the gastroesophageal junction, the fundoplication can be created over a bougie. However, this increases the risk of esophageal perforation. Therefore, we have modified a previously described technique to create a standardized fundoplication without the use of a bougie...
February 21, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Tyler Hall, Natalie Warnes, Kristine Kuchta, Stephanie Novak, Herbert Hedberg, John G Linn, Stephen Haggerty, Woody Denham, Raymond J Joehl, Michael Ujiki
BACKGROUND: The aim of this study is to investigate patient centered quality of life (QOL) outcomes in patients undergoing laparoscopic paraesophageal hernia repair (LPEHR). STUDY DESIGN: We prospectively followed patients who underwent laparoscopic paraesophageal hernia repair between 2009 - 2016. QOL outcomes were measured using Short Form-36 (SF-36), GERD-HRQL, Reflux Symptom Index, and Dysphagia score surveys administered pre-operatively and at 3 weeks, 6 months, 1 year, and 2 years post- operatively...
February 14, 2018: Journal of the American College of Surgeons
Jingliang Yan, Andrew T Strong, Gautam Sharma, Scott Gabbard, Prashanti Thota, John Rodriguez, Matthew Kroh
BACKGROUND: Systemic sclerosis (scleroderma) is frequently associated with both gastroesophageal reflux disease (GERD) and simultaneous esophageal dysmotility. Anti-reflux procedures in this patient population must account for the existing physiology of each patient and likely disease progression. We aim to compare perioperative and intermediate outcomes of fundoplication versus gastric bypass for the treatment of GERD. METHODS: After IRB approval, patients with systemic sclerosis undergoing fundoplication or gastric bypass for the treatment of GERD from 2004 to 2016 were identified...
February 12, 2018: Surgical Endoscopy
V V Ilyashenko, Viktor V Grubnyk, V V Grubnik
BACKGROUND: Primary repair of large hiatal hernia is associated with a high recurrence rate. The use of mesh can lead to a reduce of recurrence rate. Despite this reduction, the type of mesh used and the placement technique are controversial. In our study, we used a new type of non-absorbable, self-fixating mesh to reinforce the cruroplasty. The aim of the present study was to compare the long-term results of laparoscopic treatment of large hiatal hernia with mesh reinforcement versus simple crura repair...
February 8, 2018: Surgical Endoscopy
Kathleen M Coakley, Steven A Groene, Paul D Colavita, Tanushree Prasad, Dimitris Stefanidis, Amy E Lincourt, Vedra A Augenstein, Keith Gersin, B Todd Heniford
INTRODUCTION: Roux-En-Y gastric bypass (RYGB) is an alternative to reoperative fundoplication. The aim of this study was to expand long-term outcomes of patients undergoing RYGB after failed fundoplication and assess symptom resolution. METHODS: A single institution prospective study was performed of patients undergoing fundoplication takedown and RYGB between March 2007 and September 2016. Demographics, body mass index (BMI), preoperative symptoms, operative duration and findings, and postoperative outcomes were recorded...
January 23, 2018: Surgical Endoscopy
Dustin A Carlson, Peter J Kahrilas, Katherine Ritter, Zhiyue Lin, John E Pandolfino
BACKGROUND: Repetitive, retrograde contractions (RRCs) in response to sustained esophageal distension are a distinct contractility pattern observed with functional luminal imaging probe (FLIP) panometry that are common in type III (spastic) achalasia. RRCs are hypothesized to be indicative of either impaired inhibitory innervation or esophageal outflow obstruction. We aimed to apply FLIP panometry to patients with post-fundoplication dysphagia (a model of esophageal obstruction) to explore mechanisms behind RRCs...
December 21, 2017: American Journal of Physiology. Gastrointestinal and Liver Physiology
Stephen P Kinsey-Trotman, Peter G Devitt, Tim Bright, Sarah K Thompson, Glyn G Jamieson, David I Watson
OBJECTIVE: To evaluate late outcomes from a randomized trial of division versus no division of short gastric vessels during laparoscopic Nissen fundoplication at up to 20 years follow-up. BACKGROUND: Nissen fundoplication is an established procedure for the treatment of gastroesophageal reflux disease. Controversy about whether side effects such as dysphagia could be reduced by division of the short gastric vessels led to the establishment of a randomized trial in 1994...
January 4, 2018: Annals of Surgery
Sonam Kapadia, Turner Osler, Allen Lee, Edward Borrazzo
BACKGROUND: Laparoscopic fundoplication is an accepted surgical management of refractory gastro-esophageal reflux disease (GERD). The use of high resolution esophageal manometry (HRM) in preoperative evaluation is often applied to determine the degree of fundoplication to optimize reflux control while minimizing adverse sequela of postoperative dysphagia. OBJECTIVE: Assess the role of preoperative HRM in predicting surgical outcomes, specifically risk assessment of postoperative dysphagia and quality of life, among patients receiving laparoscopic Nissen fundoplication for GERD with immediate postoperative (< 4 weeks clinic), short-term (3-month clinic), and long-term (34 ± 10...
December 12, 2017: Surgical Endoscopy
J Matthew Reinersman, Dennis A Wigle, Christopher J Gostout, Louis M Wong Kee Song, Shanda H Blackmon
OBJECTIVES: The standard of care for achalasia remains laparoscopic Heller myotomy with partial fundoplication. Peroral endoscopic myotomy (POEM) has been introduced as an alternative, but safety and long-term comparative efficacy are not yet established. We report our experience in developing a POEM program using a novel hybrid approach. METHODS: We developed a hybrid approach to POEM with a POEM followed by laparoscopic evaluation, extension of the myotomy, if necessary, and partial fundoplication...
October 1, 2017: European Journal of Cardio-thoracic Surgery
Pranav Mandovra, Vishakha Kalikar, Ankur Patel, Roy V Patankar
BACKGROUND: Achalasia cardia is an esophageal motor disorder with raised lower esophageal sphincter (LES) pressure. Minimally invasive procedures have become the procedure of choice compared with conventional open surgery. After the primary surgery, recurrence or persistent symptoms have been noted in almost 10%-20% of cases. MATERIALS AND METHODS: In this case series, we share our experience with a series of 7 patients who presented to us from January 2010 to January 2017 for recurrent symptoms, following Heller's myotomy for achalasia cardia...
November 14, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Vishal Gupta, Hunaid Hatimi, Saket Kumar, Abhijit Chandra
Laparoscopic Heller's myotomy (LHM) and endoscopic balloon dilation are two main treatment modalities for achalasia cardia. The best treatment modality in Indian setting, however, is still unknown. Here, we present the early results of LHM in achalasia. Hospital data from January 2009 to October 2013 was analyzed. Preoperative assessment included Eckardt's scoring, esophagogastroduodenoscopy, barium swallow examination, and esophageal manometry. Thirty-five patients (19 males and 16 females, median age 31 years, range 12-65) underwent LHM with partial fundoplication (with intraoperative endoscopy)...
October 2017: Indian Journal of Surgery
Mindaugas Kiudelis, Egle Kubiliute, Egidijus Sakalys, Laimas Jonaitis, Antanas Mickevicius, Zilvinas Endzinas
INTRODUCTION: Two types of partial wrap are commonly performed in achalasia patients after Heller myotomy: the posterior 270° fundoplication (Toupet) and the anterior 180° fundoplication (Dor). The optimal type of fundoplication (posterior vs. anterior) is still debated. AIM: To compare the long-term rates of dysphagia, reflux symptoms and patient satisfaction with current postoperative condition between two fundoplication groups in achalasia treatment. MATERIAL AND METHODS: Our retrospective study included 97 consecutive patients with achalasia: 37 patients underwent laparoscopic posterior Toupet (270°) fundoplication followed by Heller myotomy (group I); 60 patients underwent laparoscopic anterior partial Dor fundoplication followed by Heller myotomy (group II)...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Kristy Kummerow Broman, Sharon E Phillips, Adil Faqih, Joan Kaiser, Richard A Pierce, Benjamin K Poulose, William O Richards, Kenneth W Sharp, Michael D Holzman
BACKGROUND: Our prior randomized controlled trial of Heller myotomy alone versus Heller plus Dor fundoplication for achalasia from 2000 to 2004 demonstrated comparable postoperative resolution of dysphagia but less gastroesophageal reflux after Heller plus Dor. Patient-reported outcomes are needed to determine whether the findings are sustained long-term. METHODS: We actively engaged participants from the prior randomized cohort, making up to six contact attempts per person using telephone, mail, and electronic messaging...
October 18, 2017: Surgical Endoscopy
Eduardo Rodrigues Zarco Câmara, Fernando Athayde Veloso Madureira, Delta Madureira, Renato Manganelli Salomão, Antonio Carlos Ribeiro Garrido Iglesias
BACKGROUND: All available treatments for achalasia are palliative and aimed to eliminate the flow resistance caused by a hypertensive lower esophageal sphincter. AIM: To analyze the positive and negative prognostic factors in the improvement of dysphagia and to evaluate quality of life in patients undergoing surgery to treat esophageal achalasia by comparing findings before, immediately after, and in long follow-up. METHODS: A total of 84 patients who underwent surgery for achalasia between 2001 and 2014 were retrospectively studied...
July 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Stefano Olmi, Francesco Caruso, Matteo Uccelli, Stefano Cioffi, Francesca Ciccarese, Giovanni Cesana
BACKGROUND: Gastroesophageal reflux (GERD) can be considered an obesity-related disease. Roux-en-Y gastric bypass is considered the gold standard for its therapeutic effects on acid reflux. OBJECTIVES: The aim of this retrospective study is to assess the effectiveness of combined laparoscopic sleeve gastrectomy and Rossetti antireflux fundoplication for the treatment of morbidly obese patients with GERD. SETTING: A private academic hospital in Italy...
December 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
P S S Castelijns, J E H Ponten, M C G Vd Poll, N D Bouvy, J F Smulders
INTRODUCTION: Nissen fundoplication is the golden standard for surgical treatment of gastroesophageal reflux disease (GERD). Numerous studies report excellent short-term results. However, data regarding long-term quality of life are lacking. The aim of this study is to investigate the long-term quality of life after Nissen fundoplication in patients with GERD and to compare this with the short-term results. PATIENTS AND METHODS: We retrospectively analysed all patients who underwent laparoscopic Nissen fundoplication for GERD between January 2004 and January 2016...
September 20, 2017: Journal of Minimal Access Surgery
Walid K Abu Saleh, Lee M Morris, Nabil Tariq, Min P Kim, Edward Y Chan, Leonora M Meisenbach, Brian J Dunkin, Vadim Sherman, Wade Rosenberg, Barbara L Bass, Edward A Graviss, Duc T Nguyen, Patrick Reardon, Puja G Khaitan
BACKGROUND: Primary laparoscopic hiatal repair with fundoplication is associated with a high recurrence rate. We wanted to evaluate the potential risks posed by routine use of onlay-mesh during hiatal closure, when compared to primary repair. METHODS: Utilizing single-institutional database, we identified patients who underwent primary laparoscopic hiatal repair from January 2005 through December 2014. Retrospective chart review was performed to determine perioperative morbidity and mortality...
September 15, 2017: Surgical Endoscopy
Xing Du, Ji-Min Wu, Zhi-Wei Hu, Feng Wang, Zhong-Gao Wang, Chao Zhang, Chao Yan, Mei-Ping Chen
BACKGROUND: Laparoscopic Nissen fundoplication (LNF) has been the gold standard for the surgical management of Gastro-esophageal reflux disease (GERD). Laparoscopic anterior 180° fundoplication (180° LAF) is reported to reduce the incidence of postoperative complications while obtaining similar control of reflux. The present meta-analysis was conducted to confirm the value of the 2 techniques. METHODS: PubMed, Medline, Embase, Cochrane Library, Springerlink, and China National Knowledge Infrastructure Platform databases were searched for randomized controlled trials (RCTs) comparing LNF and 180° LAF...
September 2017: Medicine (Baltimore)
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