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Dysphagia after anti reflux surgery

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
Florian Friedmacher, Birgit Kroneis, Andrea Huber-Zeyringer, Peter Schober, Holger Till, Hugo Sauer, Michael E Höllwarth
BACKGROUND: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) represent major therapeutic challenges, frequently associated with serious morbidities following surgical repair. The aim of this longitudinal study was to assess temporal changes in morbidity and mortality of patients with EA/TEF treated in a tertiary-level center, focusing on postoperative complications and their impact on long-term gastroesophageal function. METHODS: One hundred nine consecutive patients with EA/TEF born between 1975 and 2011 were followed for a median of 9...
June 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Romeo Bardini, Sabrina Rampado, Renato Salvador, Lisa Zanatta, Imerio Angriman, Silvia Degasperi, Angelica Ganss, Edoardo Savarino
BACKGROUND: Laparoscopic anti-reflux surgery has a failure rate of 10-20%. We aimed to investigate whether a modification of Nissen fundoplication (MNF) may improve patients' outcome and reduce failure rate. MATERIALS & METHODS: We prospectively compared 40 consecutive patients with gastroesophageal reflux disease who underwent anti-reflux surgery: 20 Nissen fundoplication (NF) and 20 the MNF approach. Eight cases in the MNF group needed redo surgery. The MNF consisted in suturing the esophagus to the diaphragmatic crura on each side by means of 4 non-absorbable stitches and in fixing the upper stitch of the valve to diaphragm...
February 2017: International Journal of Surgery
George Triadafilopoulos
Early in the twenty-first century, novel endoscopic techniques were introduced for the management of gastroesophageal reflux disease, providing minimally invasive ways to eliminate pharmacologic acid inhibition and avoid the need for anti-reflux surgery. These techniques do not significantly alter the anatomy of the gastroesophageal junction, minimizing short- and long-term adverse effects, such as dysphagia and bloating. After extensive clinical testing, many endoscopic therapies were abandoned due to either lack of durable efficacy or unfavorable safety profile...
September 2016: Current Gastroenterology Reports
Z W Hu, J M Wu, Z G Wang, F Wang, M P Chen, Y Y Dong, X L Zhan, Y Zhang, S S Ma, C Zhang, C Yan
OBJECTIVE: To investigate the safety and effectiveness of laparoscopic reoperation for patients with gastroesophageal reflux disease (GERD) recurred form previous anti-reflux surgery. METHODS: Totally 19 patients received laparoscopic reoperation for symptomatic and anatomic recurred GERD in Department of Gastroesophageal Reflux Disease, Rocket Force General Hospital from January 2008 to September 2015 were retrospectively analyzed. There were 12 male and 7 female patients...
July 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Arimatias Raitio, Rosie Cresner, Richard Smith, Matthew O Jones, Paul D Losty
AIM OF THE STUDY: To assess the safety and effectiveness of fluoroscopic balloon dilatation (FBD) in children with esophageal anastomotic stricture after surgical repair of esophageal atresia. METHODS: All patients undergoing surgery for esophageal atresia and requiring dilatation(s) during a consecutive 15-year period [April 2000-September 2014] were analyzed. Dilatations were performed as day case procedures under general anesthesia using a radial force generating balloon device (Boston Scientific Corporation) by surgeons...
September 2016: Journal of Pediatric Surgery
Yusuf Tanrikulu, Fatih Kar, Boran Yalcin, Gokhan Yilmaz, Volkan Temi, Mithat Cagsar
Gastro esophageal reflux disease (GERD) is the most common gastrointestinal disorder and often is associated with hiatal hernia (HH). Nissen fundoplication is the most common surgical treatment method. Despite surgical treatment, recurrence rate is still high. In this study, we aimed to identify the importance of the mesh shape in preventing recurrence after Nissen fundoplication. A hundred twenty two patients who operated Nissen fundoplication owing to GERD and/or HH were evaluated. Nissen fundoplication was made all patients...
2015: International Journal of Clinical and Experimental Medicine
Zhi-chao Tian, Bin Wang, Cheng-xiang Shan, Wei Zhang, Dao-zhen Jiang, Ming Qiu
AIM: In recent years, several studies with large sample sizes and recent follow-up data have been published comparing outcomes between laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication. It is now timely to be re-evaluated and synthesized long-term efficacy and adverse events of both total and partial posterior fundoplication. MATERIALS AND METHODS: Electronic searches for RCTs comparing the outcome after laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication were performed in the databases of MEDLINE, EMBASE, and the Cochrane Center Register of Controlled Trials...
2015: PloS One
Yu Tien Wang, Ling Fung Tai, Etsuro Yazaki, Jafar Jafari, Rami Sweis, Emily Tucker, Kevin Knowles, Jeff Wright, Saqib Ahmad, Madhavi Kasi, Katharine Hamlett, Mark R Fox, Daniel Sifrim
BACKGROUND & AIMS: Management of patients with dysphagia, regurgitation, and related symptoms after antireflux surgery is challenging. This prospective, case-control study tested the hypothesis that compared with standard high-resolution manometry (HRM) with single water swallows (SWS), adding multiple water swallows (MWS) and a solid test meal increases diagnostic yield and clinical impact of physiological investigations. METHODS: Fifty-seven symptomatic and 12 asymptomatic patients underwent HRM with SWS, MWS, and a solid test meal...
September 2015: Clinical Gastroenterology and Hepatology
Jie-Min Lv, Di-Yu Huang, Hui Lin, Xian-Fa Wang
OBJECTIVE: To evaluate the application of biological mesh in laparoscopic anti-reflux procedure for gastroesophageal reflux disease (GERD). METHODS: The clinical data of 20 consecutive GERD patients underwent anti-reflux surgery in Sir Run Run Shaw Hospital from December 2012 to April 2014 were retrospectively analyzed. The laparoscopic hiatal repair with 360 fundoplicaiton was performed and the biological mesh (BiodesignTM, Surgsis) was implanted for reinforcement of hiatal repair...
January 2015: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
I M Shapey, S Agrawal, A Peacock, P Super
INTRODUCTION: Laparoscopic partial fundoplication for gastro-oesophageal reflux disease (GORD) is reported to have fewer side effects when compared to Nissen fundoplication, but doubts remain over its long term durability in controlling reflux. The aim of this study was to assess outcome of symptoms for all patients presenting with GORD undergoing routine laparoscopic subtotal Lind fundoplication. MATERIALS & METHODS: All patients undergoing laparoscopic fundoplication between August, 1999 and November, 2007 performed by a single surgeon were included in the study...
January 2015: International Journal of Surgery
Reginald C W Bell, Ashwin A Kurian, Katherine D Freeman
BACKGROUND: Transoral incisionless fundoplication (TIF) treats gastroesophageal reflux disease (GERD) by creating a full-thickness esophagogastric plication using transmural fasteners. If unsuccessful, revision laparoscopic anti-reflux surgery (rLARS) may be performed. This study evaluated operative findings and clinical outcomes of rLARS in 28 patients with prior primary TIF. METHODS: Intraoperative findings, complications, and symptomatic outcomes with GERD health-related quality of life (GERD-HRQL) were evaluated prospectively in patients having rLARS after TIF...
July 2015: Surgical Endoscopy
Franco G Marinello, Eduardo M Targarona, Carmen Balague, María Poca, Joan Mones, Manuel Trias
INTRODUCTION: Laparoscopic Heller myotomy has become the gold standard procedure for patients with achalasia. This study evaluates the clinical status, quality of life, and functional outcomes after laparoscopic Heller myotomy. MATERIAL AND METHODS: We analyzed patients who underwent laparoscopic Heller myotomy with an associated anti-reflux procedure from October 1998 to December 2010. Before surgery, we administered a clinical questionnaire and as of 2002, we also evaluated quality of life using a specific questionnaire (GIQLI)...
March 2014: Cirugía Española
Priscila Guyt Rebelo, João Victor C Ormonde, João Baptista C Ormonde Filho
OBJECTIVE To emphasize the need of an accurate diagnosis of congenital esophageal stenosis due to tracheobronchial remnants, since its treatment differs from other types of congenital narrowing. CASE DESCRIPTION Four cases of lower congenital esophageal stenosis due to tracheobronchial remnants, whose definitive diagnosis was made by histopathology. Except for the last case, in which a concomitant anti-reflux surgery was not performed, all had a favorable outcome after resection and anastomosis of the esophagus...
September 2013: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
A Ilczyszyn, A J Botha
Increased esophagogastric junction distensibility has been implicated in the development of gastroesophageal reflux disease (GERD). Previous authors have demonstrated a reduction in distensibility following anti-reflux surgery, but the changes during the operation are not clear. Our study aimed to ascertain the feasibility of measuring intraoperative distensibility changes and to assess if this would have potential to modify the operation. Seventeen patients with GERD were managed in a standardized manner consisting of preoperative assessment with symptom scoring, endoscopy, 24 hours pH studies, and manometry...
September 2014: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
M J Smits, C M Loots, M A Benninga, T I Omari, M P van Wijk
In children with gastroesophageal reflux (GER) disease refractory to pharmacological therapies, anti-reflux surgery (fundoplication) may be a treatment of last resort. The applicability of fundoplication has been hampered by the inability to predict which patient may benefit from surgery and which patient is likely to develop post-operative dysphagia. pH impedance measurement and conventional manometry are unable to predict dysphagia, while the role of gastric emptying remains poorly understood. Recent data suggest that the selection of patients who will benefit from surgery might be enhanced by automated impedance manometry pressure-flow analysis (AIM) analysis, which relates bolus movement and pressure generation within the esophageal lumen...
October 2013: Current Gastroenterology Reports
D C Lin, C L Chun, G Triadafilopoulos
Over the past two decades, there has been an increase in the number of anti-reflux operations being performed. This is mostly due to the use of laparoscopic techniques, the increasing prevalence of gastroesophageal reflux disease (GERD) in the population, and the increasing unwillingness of patients to take acid suppressive medications for life. Laparoscopic fundoplication is now widely available in both academic and community hospitals, has a limited length of stay and postoperative recovery time, and is associated with excellent outcomes in carefully selected patients...
January 2015: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Georg R Linke, Tobias Gehrig, Lena V Hogg, Anna Göhl, Hannes Kenngott, Fritz Schäfer, Lars Fischer, Carsten N Gutt, Beat P Müller-Stich
PURPOSE: Laparoscopic hiatal hernia repair with additional fundoplication is a commonly recommended standard surgical treatment for symptomatic large hiatal hernias with paraesophageal involvement (PEH). However, due to the risk of persistent side effects, this method remains controversial. Laparoscopic mesh-augmented hiatoplasty without fundoplication (LMAH), which combines hiatal repair and mesh reinforcement, might therefore be an alternative. METHODS: In this retrospective study of 55 (25 male, 30 female) consecutive PEH patients, the perioperative course and symptomatic outcomes were analyzed after a mean follow-up of 72 months...
May 2014: Surgery Today
Huiqi Yang, Cindy Meun, Xiangyu Sun, David I Watson
BACKGROUND: Some patients develop troublesome dysphagia after laparoscopic antireflux surgery, and a proportion require further intervention. The management of this problem was evaluated. METHODS: Patients who underwent intervention for dysphagia after laparoscopic fundoplication were identified from a database. Outcomes were prospectively determined from a standardized questionnaire that evaluated symptoms scores for dysphagia for solids and liquids, as well as patient satisfaction with the overall outcome...
April 2012: World Journal of Surgery
Felipe Pacheco-Barzallo, Williams Arias-Garzón, Javier Rodríguez-Suárez, Analía Carrera-Hidalgo
BACKGROUND: Leiomyoma is the most common benign esophageal tumor that originates in the muscular layer, with the most common site located in the distal third of the esophagus. Its growth causes symptoms due to partial obstruction of the esophageal lumen, leading to the diagnosis and subsequent treatment. Today, due to modern minimally invasive surgical techniques, complete removal of these tumors can be accomplished with minimal morbidity and excellent results. CASE REPORT: We report the case of a 49-year-old female with a history of dysphagia, epigastric pain, and halitosis...
November 2011: Cirugia y Cirujanos
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