Esophagueal reflux

Among the multiple congenital defects associated to esophagueal atresia, the characteristic ones of the Goldenhar syndrome usually are not included. The high incidence has been reported, about 5% of esophagueal atresia in patients with Goldenhar syndrome. Our experience includes two patients with this association who presented anesthetic problems and surgical complications associated with gastroesophageal reflux and esophageal anastomosis.

The gastroesophageal reflux (GER) disease is a very frequent digestive disorder, mainly characterised by the reflux of the gastric acidic content to the esophage in abnormal quantities. There are different situations that favour this situation but almost in all of them rely an incompetence of the esophagic sphincter. The clinical consequences are many, including oral manifestations. Among all of them the most frequent is the esophagitis followed by symptoms at the pharynx or larynx and finally, the oral cavity...

The gastrointestinal tract undergoes change with aging, and the esophagus is not exempt from those changes. Failure of peristalsis in the older esophagus was labeled "presbyesophagus" over 35 years ago. Modern manometric techniques and classification systems have challenged this concept, yet there are clearly age-related changes in the esophagus. The lower esophageal sphincter changes little. Esophageal peristalsis (body) is more likely to fail in older patients, but some of this failure may be caused by damage from gastroesophageal reflux disease...

Description and substantiation of the method of surgical treatment and prophylaxis of reflux-esophagitis are given it rejects restoration of acute angle of this. And on the contrary, pulling cardia upwards along the esophagus by 3-6 cm makes the 90 degrees and more. New anatomical arrangement of abdominal part of the esophague and the stomach is fixed by incomplete fundoplication around the esophague at 2/3 of its circumference. The experience in usage of this method in 93 patients with diaphragmatic hiatal hernia and patients with ulcer and other diseases is analysed...