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hernia, gerd, reflux

Matthias Sauter, Mark Robert Fox
Increased acid reflux after meals is a key feature of gastro-esophageal reflux disease (GERD) and is the most important cause for patient symptoms, particularly heartburn and acid regurgitation. Chronic acid exposure also predisposes to associated pathologies including reflux esophagitis, esophageal stricture, Barrett's esophagus, and Barrett's carcinoma (esophageal adenocarcinoma). The severity of esophageal symptoms and mucosal damage is related to two key factors, (i) the acidity of the refluxate, which depends primarily on the gastric secretory output and its distribution within the stomach, and (ii) the frequency and duration of reflux events which depends on the efficacy of the reflux barrier at the gastro-esophageal junction and the esophageal clearance function...
October 2018: Zeitschrift Für Gastroenterologie
Bassem Abou Hussein, Ali Khammas, Mariam Shokr, Maiyasa Majid, Mariam Sandal, Sameer Al Awadhi, Alya Al Mazrouei, Faisal Badri
Introduction  The routine use of preoperative endoscopy for patients undergoing bariatric surgery is controversial. Although many surgeons find it unnecessary, others still consider it a mandatory tool in preoperative assessment. Patients and methods  We reviewed the medical records of all patients who had undergone preoperative endoscopy before bariatric surgery in Rashid Hospital between January 2013 and June 2016. The patients were divided into three groups: Group 0 included patients with normal endoscopy; Group 1 included patients with abnormalities that did not affect the timing or type of procedure; Group 2 included patients with abnormalities that had a direct impact on the procedure...
October 2018: Endoscopy International Open
Priscila R Armijo, Dietric Hennings, Melissa Leon, Akshay Pratap, Austin Wheeler, Dmitry Oleynikov
BACKGROUND: Gastroesophageal reflux disease (GERD) and esophageal dysmotility are often disqualifying criteria for fundoplication due to dysphagia complications. A tailored partial fundoplication may improve GERD in patients with severe esophageal motility disorders. We evaluate this approach on GERD improvement in non-achalasia esophageal dysmotility patients. METHODS: A single-institution prospective database was reviewed (2007-2016), with inclusion criteria of GERD, previous diagnosis of non-achalasia esophageal motility disorder, and laparoscopic partial fundoplication...
October 4, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Chin Hong Lim, Phong Ching Lee, Eugene Lim, Jeremy Tan, Weng Hoong Chan, Hong Chang Tan, Sonali Ganguly, Kwang Wei Tham, Alvin Eng
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has become the preferred bariatric procedure in many countries. However, there is one shortcoming of LSG in the long-term follow-up and this is the onset of GERD and erosive esophagitis (EE). Current evidence of the effect of SG on GERD did not consolidate to a consensus. In this study, we objectively evaluate the incidence of EE 1 year post-LSG with upper endoscopy (EGD) and try to identify the significant variables and possible underlying mechanisms of the EE post-LSG...
September 21, 2018: Obesity Surgery
Nobuo Omura, Fumiaki Yano, Kazuto Tsuboi, Masato Hoshino, SeRyung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Hideyuki Kashiwagi, Katsuhiko Yanaga
BACKGROUND: Surgical results of GERD have mainly been reported from the Western countries, with a few reports found in Japan. We examined the surgical results of laparoscopic Toupet fundoplication and clarify the characteristics of recurrent cases. METHODS: The subjects included 375 patients who underwent laparoscopic Toupet fundoplication from June 1997 to December 2016 as the initial surgery. Patient characteristics, pathophysiology, and surgical results were examined...
October 2018: Esophagus: Official Journal of the Japan Esophageal Society
Jimin Han, Matthew Chin, Kyle J Fortinsky, Reem Sharaiha, Christopher J Gostout, Kenneth J Chang
Background and study aims  This preliminary study was conducted to determine the feasibility and safety of endoscopic augmentation of the gastroesophageal junction (GEJ) using the Apollo OverStitch endoscopic suturing system in patients with gastroesophageal reflux disease (GERD) symptoms. Patients and methods  Endoscopic augmentation of GEJ was performed on 10 consecutive patients and the data were analyzed retrospectively. Using a double-channel gastroscope affixed to the endoscopic suturing platform, interrupted sutures were placed on the gastric side of the GEJ in 2 layers in order to create a narrowed and elongated GEJ...
September 2018: Endoscopy International Open
Dario Amore, Carlo Bergaminelli, Davide Di Natale, Dino Casazza, Roberto Scaramuzzi, Carlo Curcio
Morgagni hernia is a relatively uncommon congenital diaphragmatic hernia in which abdominal contents protrude into the chest through the foramen of Morgagni. It usually occurs on the right side of the chest but may occur on the left side or in the midline. In adults, it commonly presents with non-specific symptoms such as dyspnea, cough, gastroesophageal reflux disease and other. Surgical repair should be always performed to prevent the risk of hernia incarceration. Transthoracic approach has been proposed especially in cases with indeterminate, anterior pericardial masses...
July 2018: Journal of Thoracic Disease
Alexandra Argyrou, Evangelia Legaki, Christos Koutserimpas, Maria Gazouli, Ioannis Papaconstantinou, George Gkiokas, George Karamanolis
Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder with an increasing prevalence. GERD develops when the reflux of stomach contents causes troublesome typical and atypical symptoms and/or complications. Several risk factors of GERD have been identified and evaluated over the years, including a considerable amount of genetic factors. Multiple mechanisms are involved in the pathogenesis of GERD including: (1) motor abnormalities, such as impaired lower esophageal sphincter (LES) resting tone, transient LES relaxations, impaired esophageal acid clearance and delayed gastric emptying; and (2) anatomical factors, such as hiatal hernia and obesity...
August 16, 2018: World Journal of Clinical Cases
U Hesse, J Lenz, L Thumfart, H Stein
BACKGROUND: The introduction of robot-assisted surgery in the treatment of morbidly obese patients has enlarged the armamentarium for surgeons involved in bariatric surgery. This article describes the experiences with a conversion surgery from a complicated open Mason gastroplasty to a Roux en Y gastric bypass using the da Vinci Xi robotic system. CASE: A 29-year-old female patient underwent a Mason reduction gastroplasty by laparotomy in 1995 (body mass index BMI 53...
October 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Emanuele Asti, Alberto Aiolfi, Veronica Lazzari, Andrea Sironi, Matteo Porta, Luigi Bonavina
Use of the magnetic sphincter augmentation (MSA) device for the laparoscopic treatment of gastroesophageal reflux disease is increasing since the first clinical implant performed a decade ago. The MSA procedure is a minimally invasive and highly standardized surgical option for patients who are partially responders to proton-pump inhibitors, which have troublesome regurgitation or develop progressive symptoms despite continuous medical therapy. The procedure has proven to be highly effective in improving typical reflux symptoms, reducing the use of proton-pump inhibitors, and decreasing esophageal acid exposure...
September 2018: Updates in Surgery
James M Tatum, Evan Alicuben, Nikolai Bildzukewicz, Kamran Samakar, Caitlin C Houghton, John C Lipham
BACKGROUND: The magnetic sphincter augmentation (MSA) device was initially implanted with minimal hiatal dissection (MHD) at the diaphragmatic hiatus. Due to concern of possible MSA device dysfunction if herniated into an occult or small hiatal hernia, and increased understanding to the role of defective crura in reflux disease, the operative procedure was changed to planned obligatory dissection (OD) of the hiatus at the time of all implantations. METHODS: Between December 2012 and September 2016, 182 patients underwent MSA implant at a single medical center and have complete records available for review through September 2017...
July 13, 2018: Surgical Endoscopy
Antono C Valezi, Fernando A M Herbella, Francisco Schlottmann, Marco G Patti
Gastroesophageal reflux disease (GERD) and obesity coexist in many patients in the Western population. The association is not coincidental, since GERD pathophysiology is, in part, linked to obesity. Visceral adipose tissue secretes hormones, which increase the risk of GERD. Obesity increases esophageal motor disorders and higher number of transient lower esophageal sphincter relaxations. Central obesity increases abdominal-thoracic pressure gradient and disrupts the gastroesophageal junction by inducing hiatal hernia formation...
August 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Yves Borbély, Esther Schaffner, Lara Zimmermann, Michael Huguenin, Gabriel Plitzko, Philipp Nett, Dino Kröll
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has become the most frequently performed bariatric procedure to date. However, LSG is known to worsen pre-operative and result in de novo gastroesophageal reflux disease (GERD). Pre-operative evaluation reveals a high percentage of silent GERD of so far unknown influence on post-operative GERD. METHODS: Prospective data of patients undergoing primary LSG between 01/2012 and 12/2015 were evaluated. Pre-operative GERD-specific evaluation consisted of validated questionnaires, upper endoscopy, 24 h-pH-manometry, and esophagograms...
July 12, 2018: Surgical Endoscopy
Natalia Dowgiałło-Wnukiewicz, Agata Frask, Paweł Lech, Maciej Michalik
Introduction: Gastroesophageal reflux disease (GERD), demonstrated to impair quality of life (QoL), appears to show significant variation in its prevalence. Estimation of the prevalence is difficult. When defined as at least weekly heartburn and/or acid regurgitation, the prevalence reported in Asia is 2.5-27.6%, in Europe 23.7% and in the US 28.8%. Aim: The study evaluates the prevalence of GERD symptoms in the assessment of the GERD Impact Scale (GERD-IS) in two age groups of patients...
June 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Tagore Sunkara, Emmanuel Ofori, Krishna Sowjanya Yarlagadda, Vinaya Gaduputi
Gastric mucosal prolapse (GMP) is a rare clinical syndrome that in patients with hiatal hernias and gastroesophageal reflux disease (GERD) may present with typical findings of abdominal pain and reflux symptoms but prove resistant to medical therapy. Physicians should therefore be aware and consider GMP as a differential in such patients in order to make an accurate diagnosis and provide timely treatment.
July 2018: Clinical Case Reports
Khus Raj Dewan, Bhanumati Saikia Patowary, Subash Bhattarai, Gaurav Shrestha
BACKGROUND: Barrett's esophagus a is metaplasia of normal squamous cells that line the lower part of the esophagus and carries a major risk for adenocarcinoma of esophagus. In Asian population, the prevalence of Barrett's esophagus and adenocarcinoma are less common than in Western countries but has been increasing. METHODS: This is a hospital based descriptive study comprising of 120 consecutive patients with symptoms of gastroesophagial reflux disease belonging to both sexes of any age group...
July 3, 2018: Journal of Nepal Health Research Council
Francisco Schlottmann, Ciro Andolfi, Fernando A Herbella, Fabrizio Rebecchi, Marco E Allaix, Marco G Patti
A hiatal hernia (HH) is a frequent finding in patients with gastroesophageal reflux disease (GERD). We examined a consecutive series of patients with GERD diagnosed by a 24-hour pH monitoring. Based on the presence and size of HH on barium swallow, patients were divided into the following groups: no HH, HH <3 cm, HH 3-5 cm and HH >5 cm. A total of 175 patients were included: 43 with no HH, 86 with HH <3 cm, 34 with HH 3-5 cm, and 12 with HH >5 cm. Patients with larger HH had more frequent episodes of coughing and wheezing associated with episodes of reflux...
June 1, 2018: American Surgeon
Al-Warith Al Hashmi, Guillaume Pineton de Chambrun, Regis Souche, Martin Bertrand, Vito De Blasi, Eric Jacques, Santiago Azagra, Jean Michel Fabre, Frédéric Borie, Michel Prudhomme, Nicolas Nagot, Francis Navarro, Fabrizio Panaro
BACKGROUND: Nearly 20% of patients who undergo hiatal hernia (HH) repair and anti-reflux surgery (ARS) report recurrent HH at long-term follow-up and may be candidates for redo surgery. Current literature on redo-ARS has limitations due to small sample sizes or single center experiences. This type of redo surgery is challenging due to rare but severe complications. Furthermore, the optimal technique for redo-ARS remains debatable. The purpose of the current multicenter study was to review the outcomes of redo-fundoplication and to identify the best ARS repair technique for recurrent HH and gastroesophageal reflux disease (GERD)...
June 25, 2018: Surgical Endoscopy
Stefano Siboni, Emanuele Asti, Pamela Milito, Gianluca Bonitta, Andrea Sironi, Alberto Aiolfi, Luigi Bonavina
BACKGROUND: Laparoscopic surgery has proven safe and effective in the treatment of large hiatus hernia. Differences may exist between objectively assessed surgical outcomes, symptomatic scores, and patient-reported outcomes. METHODS: An observational, single-arm cohort study was conducted in patients undergoing primary laparoscopic repair with crura mesh augmentation and Toupet fundoplication for large (> 50% of intrathoracic stomach) type III-IV hiatus hernia...
June 20, 2018: Digestive Surgery
Xiang-Xing Li, Jie Liu, You-Lian Chen, Guang-Jian Chen, Zhen-Yu Wang, Jun-Jun Zhu, Yun-Wei Guo, Xiu-Qing Wei
BACKGROUND Adrenal insufficiency is mainly due to insufficient adrenal corticosteroid hormones secretion by the adrenal cortex, which leads to clinical manifestations such as weakness, weight loss, hyperpigmentation, hypotension, and vomiting. However, the clinical manifestations of adrenocortical insufficiency may be atypical: anorexia, ascites, impaired liver function, and alacrima have been reported. Jaundice and anorexia presenting together in the same patient as the main symptoms are rare. CASE REPORT We present a rare case of a 65-year-old woman diagnosed as having adrenocortical insufficiency with chief complaints of anorexia and jaundice...
June 18, 2018: American Journal of Case Reports
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