Esophagogastric fundoplasty (Total 5525 Papers Found)

BACKGROUND Laparoscopic Nissen fundoplication (LNF) has become the method of choice in the surgical treatment of gastroesophageal reflux disease (GERD), replacing its open counterpart without confirmation by the long-term results of controlled clinical studies. The goal of the present study was to compare the 15-year outcome of a randomized controlled comparison study of LNF versus open Nissen fundoplication (ONF). METHODS From 1992 to 1995, 110 consecutive patients were randomized to undergo ...
The use of radiofrequency energy (RFe) treatment at the gastroesophageal junction (GEJ) has been considered an alternative to surgery after fundoplication disruption. It is unknown whether the recommended delivery technique for primary gastroesophageal reflux disease applies to an anatomically altered GEJ following fundoplication. The aim of this study was to determine whether modifications to the standard technique using fluoroscopic guidance more accurately localizes ablation zones compared wi ...
Although gastroparesis does not influence gastroesophageal reflux disease (GERD) or antireflux surgery, many patients with GERD will also suffer from gastroparesis-related bloating as a distinct symptom different from GERD-related symptoms. The purpose of this study was to assess whether a pyloroplasty with a fundoplication will improve bloating symptoms in these patients. A prospectively gathered database of all patients undergoing antireflux surgery was reviewed. All patients underwent history ...
Fundoplication provides excellent control of gastro-oesophageal reflux disease (GORD), but there remain a number of unsatisfied patients who have proven difficult to identify pre-operatively. We hypothesised that pre-operative symptom patterns can predict of the risk of post-operative dissatisfaction. Pre-operative symptoms and post-operative satisfaction were measured using standardised questionnaires along with routine investigations. These data were used to calculate our novel pre-operative r ...
Laparoscopic Nissen fundoplication is the treatment of choice for medically refractive gastro-oesophageal reflux disease as it is considered safe, cost efficient and effective. Unusual variants of internal abdominal herniation, however, have been reported after the procedure. Here, we present a case of a 38-year-old woman who presented 3 months after a successful laparoscopic Nissen Rossetti fundoplication, with abdominal pain and persistent vomiting. Abdominal X-ray at the time of admission wa ...
Functional disorders such as delayed gastric emptying, dumping syndrome or duodeno-gastro-esophageal reflux occur in half of the patients who undergo esophagectomy and gastric tube reconstruction for cancer. The potential role for pyloroplasty in the prevention of functional disorders is still debated. Antireflux fundoplication during esophagectomy can apparently reduce the reflux but at the cost of increasing the complexity of the operation; it is not widely used. The treatment of functional di ...
In 18 dogs esophagocardioplasty was performed through an abdominal incision with a gastric patch taken from the minor curvature of the stomach. In four dogs the mucosa was removed from the gastric patch and in six dogs a Nissen fundoplication was done. The dogs were observed for 1 year. All dogs showed macroscopic and microscopic signs of esophagitis with ulcers; three had esophageal perforation and two dogs had esophageal stenosis. We found that gastric patches with peptic acid secretory mucosa ...
The Nissen fundoplication is the most frequently applied antireflux operation worldwide. The aim of this review was to compare laparoscopic Nissen with partial fundoplication. Nine randomized trials comparing several types of wraps were analyzed, four for the comparison Nissen vs. Toupet and five for the comparison Toupet or Nissen vs. anterior fundoplication. Similar comparisons in nonrandomized studies were also included. Dysphagia rates and reflux recurrence were not related to preoperative e ...
Laparoscopic Nissen fundoplication is effective for treating gastroesophageal reflux and is usually well tolerated. Some patients, however, experience postoperative dysphagia refractory to conservative measures. We report our experience and operative technique for laparoscopic conversion of previous laparoscopic Nissen fundoplication to partial fundoplication to relieve dysphagia. We retrospectively reviewed the medical records of 6 patients with refractory dysphagia after laparoscopic Nissen fu ...
Although primary band placement is proven to be safe, gastric band placement after previous operations in the area of the gastroesophageal junction remains controversial. Erosion into the stomach has been described after failed vertical banded gastroplasty conversion to laparoscopic gastric banding (LAGB), but no reports in the English literature are available on erosion of an adjustable gastric band into the esophagus after conversion operations. To our knowledge, this is the first case report ...
BACKGROUND Although rare, esophageal achalasia is the best described primary esophageal motility disorder. Commonly used treatments are endoscopic botulin toxin injection (EBTI), endoscopic balloon dilation (EBD), and surgical myotomy with or without a fundoplication; however, reported outcomes mostly come from cohort studies. OBJECTIVE To summarize and compare the safety and efficacy of endoscopic and surgical treatments for esophageal achalasia. METHODS A systematic electronic Medline lite ...
With advancements in minimal access surgery, combined laparoscopic procedures are now being performed for treating coexisting abdominal pathologies at the same surgery. In our center, we performed 145 combined surgical procedures from January 1999 to December 2002. Of the 145 procedures, 130 were combined laparoscopic/endoscopic procedures and 15 were open procedures combined with endoscopic procedures. The combination included laparoscopic cholecystectomy, various hernia repairs, and gynecologi ...
BACKGROUND There is today a significant greater number of laparoscopic antireflux procedures for the surgical treatment of gastroesophageal reflux disease and there are yet controversies about the necessity of division of the short gastric vessels and full mobilization of the gastric fundus to perform an adequate fundoplication. AIM To verify the results of the surgical treatment of non-complicated gastroesophageal reflux disease performing Rossetti modification of the Nissen fundoplication. P ...
A vascular interruption to the azygoportal zone, achieved by devascularisation about the cardia and a closed transmural ligation of the varices is described, which is combined with a simultaneous truncal vagotomy, pyloroplasty procedure and a fundoplication. This fourfold method combats the bleeding varices at several points: a direct disruption of vascular paths, haemodynamic control, reduced influence of peptic factors, the management of coincident ulcer pathology and the prevention of gastro- ...
Organo-axial gastric volvulus is a rare postoperative complication of stomach surgeries. A case is presented in which a 43-year-old patient developed acute gastric volvulus 14 months after a laparoscopic fundoplication, diagnosed by preoperative CT scan, and treated by reduction of the volvulus, closing the gap in the pars flaccida, and a sham gastro-jejunostomy, all done laparoscopically. This is being published to highlight one of the rare complications of gastric surgery, which can be treate ...
Large paraesophageal hernias are generally repaired by reduction of the stomach into the abdomen, sac excision, crural closure, and gastropexy or fundoplication. After gaining experience performing laparoscopic repair of sliding hiatal hernias and Nissen fundoplication we combined laparoscopic access with traditional surgical technique in treating patients with complex paraesophageal hernias. Ten adults, six males and four females, with type III paraesophageal hernias underwent laparoscopic repa ...
BACKGROUND Discrepancies between arterial carbon dioxide (P(a)CO(2)) and endtidal carbon dioxide (ETCO(2)) measures have been demonstrated in ventilated children with cyanotic congenital heart disease, infants with respiratory failure and during visceral and urological laparoscopic surgery. OBJECTIVES Our objective was to assess the extent of the P(a)CO(2) to ETCO(2) gradient in children during laparoscopic fundoplication. METHODS We prospectively collected data on patient characteristics, s ...
Background: Gastroesophageal reflux Disease is a highly prevalent gastrointestinal (GI) disorder and is one of the most common GI illnesses encountered in clinical practice. Gastroesophageal reflux disease (GERD) is one of the most common conditions presenting to primary care physicians and gastroenterologists. It refers to the abnormal exposure of the oesophageal mucosa to refluxed gastric contents, including acid and pepsin, resulting in symptoms and/or tissue damage. Our aim was to compare th ...
Dysphagia is a common postoperative symptom after laparoscopic antireflux surgery, usually attributed to postoperative edema or a “too tight” fundoplication. Although it is usually self-limited, it occasionally requires endoscopic dilation and rarely revisionary surgery. It has not been previously described whether postoperative dysphagia is associated with poorer long-term reflux control after fundoplication. We hypothesized that the presence of dysphagia in the early postoperative period i ...
  • L Punto, Risto E. Mokka,
  • RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin
  • 1978
Following Nissen fundoplication, there is incomplete correlation between the radiological appearances and the patients' subjective symptoms. Radiology is nevertheless an important method of examination after operation. Conventional barium examination with fluoroscopy readily demonstrates the anatomical changes. Dynamic changes, such as oesophageal reflux or delayed contrast passage, are also demonstrated by cine radiography. ...
This study presents a modified surgical approach to laparoscopic myotomy for achalasia using stepped dilation with a Rigiflex balloon and contrast medium under image guidance. A 10-year-old boy with persistent dysphagia and vomiting had ingested only liquids for 3 months, losing >10 kg in body weight. Barium swallow and esophageal manometry diagnosed esophageal achalasia with mild esophageal dilatation. After failed pneumatic dilatation, laparoscopic Heller myotomy with Dor fundoplication w ...
INTRODUCTION Laparoscopic Nissen operation with mesh reinforcement remains being the most popular operation for large hiatal hernia repair. Complications related to mesh placement have been widely described. Cardiac complications are rare, but have a fatal outcome if they are misdiagnosed. PRESENTATION OF CASES We sought to outline our institutional experience of three patients who developed cardiac complications following a laparoscopic Nissen operation for large hiatal hernia repair. DISCU ...
To present the medium to long-term outcome of the largest pediatric series of laparoscopic Toupet fundoplications (LTF) performed at a single institution. Subjects were 131 neurologically impaired children (81 M, 50 F) who underwent LTF between 2003 and 2013. Our LTF involves full dissection of the crus of the diaphragm to allow the intraabdominal esophagus to be mobilized at least 3–4 cm. Preoperative mean fraction time for pH <4 was 14.6 %. Mean age at LTF was 6.7 years (3 months–1 ...
From 1972 to 1985, 101 consecutive patients underwent Heller's myotomy and Belsey repair (H + B) (n = 43) or Nissen fundoplication (H + N) (n = 58) for achalasia of the esophagus. There was no operative mortality after either operation; minor pulmonary complications occurred after H + B procedure in 9.3 per cent of the patients. Good to excellent long term results were achieved in 87 per cent of the patients after H + B repair and 83 per cent of the patients undergoing H + N. The failure rates w ...
It is presented our experience and review of literature of pathogenesis, symptomatology, diagnostics and surgical treatment of gastroesophageal reflux desease (GERD). A cohort of 104 patients (67 males and 37 females, median age - 42.5) who underwent "open" A. Chernousov modified Nissen fundoplication was evaluated for an follow-up period more than 10 years. In 23 cases with concomitant duodenal ulcer and gastric hypersecretion selective proximal vagotomy additionally was performed, 3 of them al ...
There are no prospective studies available on the behavior of extraesophageal and esophageal symptoms and treatment-related side effects in patients without effective antireflux medication, receiving the most effective antireflux medication, and after laparoscopic fundoplication. Extraesophageal and esophageal reflux symptoms and treatment-related side effects were assessed in 60 patients while they were on no effective antireflux medication (three-week washout period), after three month of trea ...
An unusual postoperative complication of ulceration and hemorrhage during the postoperative period of a Nissen fundoplication in a patient with severe chronic periesophagitis is presented. In a review of the literature we could not find a similar report. The possible etiopathogenic mechanisms are discussed, and preventive measures are suggested. ...
Obesity has been implicated as an important risk factor for fundoplication failure. However, the mechanism of fundoplication in obese patients is not fully understood. Our objective is to evaluate the patterns of failure in relation to the body mass index (BMI) undergoing re-operative intervention after failed fundoplication. After Institutional Review Board approval, the patients who underwent re-operative intervention for failed fundoplication between November 2008 and December 2013 were ident ...
Primary laparoscopic hiatal hernia repair is associated with up to a 42% recurrence rate. This has lead to the use of mesh for crural repair, which has resulted in an improved recurrence rate (0–24%). However, mesh complications have been observed. We compiled two cases, and our senior author contacted other experienced esophageal surgeons who provided 26 additional cases with mesh-related complications. Care was taken to retrieve technical operative details concerning mesh size and shape and ...
The purpose of this study was to evaluate the results of a fundoplication aimed to avoid complications of the Nissen procedure. The procedure combined a posterior hemifundoplication and a short circular fundoplication and their fixation to crura. A total of 67 consecutive patients were prospectively evaluated before and after surgery (median follow-up 24 months). Typical and atypical signs of reflux were present in 96.9% and 28.1% of cases, respectively, before operation versus 12.5% and 6.3% af ...
GRUNDLAGEN: In den letzten Jahren sind verschiedene endoskopische Techniken zur Therapie der gastroösophagealen Refluxkrankheit (GERD) entwickelt und auf den Markt gebracht worden. Ziel dieser Methoden ist, eine – im Gegensatz zur chronischen Einnahme von Protonenpumpeninhibitoren – definitive Therapie anzubieten, die – im Vergleich zur operativen Fundoplikatio – mit geringerem Risiko einhergehen soll. METHODIK: Die derzeit verfügbaren klinischen Daten zu den endoskopischen Antirefluxv ...
BACKGROUND/AIMS Reflux of bile to the oesophagus has been shown to be of importance in the development of gastro-oesophageal reflux disease. This study aims to assess oesophageal motility patterns in relation to acid and bile reflux to the oesophagus. METHODS Forty-nine subjects with and without reflux disease underwent 24-hour ambulatory recordings of oesophageal pH, bile and 3-channel manometry. Gastroscopy was performed to assess severity of oesophagitis. The percentage of effective perista ...
A paraesophageal hernia was diagnosed in a 67-year-old female patient suffering from epigastric pain and gastroesophageal reflux disease. The patient underwent laparoscopy. Beside the paraesophageal hernia, a Morgagni hernia was also observed, with a significant part of the omentum herniated in the sac. A 360-degree Nissen fundoplication was performed, the Morgagni hernia sac was not resected, and its closure was performed with interrupted sutures. No complications were observed in the postopera ...
  • Tanja Gonska,
  • Journal of pediatric gastroenterology and nutrition
  • 2016
4. Francis DO, Goutte M, Slaughter JC, et al. Traditional reflux parameters and not impedance monitoring predict outcome after fundoplication in extraesophageal reflux. Laryngoscope 2011;121:1902–9. 5. Patel A, Sayuk GS, Gyawali CP. Parameters on esophageal pHimpedance monitoring that predict outcomes of patients with gastroesophageal reflux disease. Clin Gastroenterol Hepatol 2015;13:884– 91. 6. Rosen R, Levine P, Lewis J, et al. Reflux events detected by pH-MII do not determine fundoplicat ...
Failure of hiatal closure has proven to be the most frequent complication leading to revisional surgery after primary failed open or laparoscopic antireflux surgery. To prevent hiatal hernia recurrence some authors recommend the use of prosthetic meshes for reinforcement of the hiatal crura. The aim of the present prospective study was to evaluate the safety and effectiveness of a circular hiatal onlay mesh prosthesis applied during laparoscopic refundoplication after primary failed antireflux s ...
OBJECTIVES Herniation of the fundoplication wrap through the esophageal hiatus is a common reason for surgical failure in children who have undergone laparoscopic Nissen fundoplication. Extensive mobilization of the gastroesophageal junction in combination with decreased adhesions after laparoscopy may contribute to the development of this complication. In an attempt to decrease the incidence of wrap migration, we changed our technique to minimal mobilization of the intraabdominal esophagus and ...
A 78-YEAR-OLD WOMAN PRESENTED WITH A 9-year history of hoarseness, which had substantially progressed in the 12 months before presentation. Her medical history was remarkable for gastroesophageal reflux, which had been treated with Nissen fundoplication 2 years earlier. The results of a Bravo pH study performed 1 year earlier were negative. The patient had a 50 pack-year smoking history and had stopped using tobacco 9 years ago. Her vocal quality was strained and harsh, with normal frequency and ...
BACKGROUND This is a retrospective review from March 1994 through October 1996 of 78 patients who underwent laparoscopic Nissen fundoplication for gastroesophageal reflux disease (GERD). The purpose of this study was to evaluate the postoperative results and complications. METHODS The patient profile included 38 men and 40 women with a mean age of 46 years (range 11 to 81). The main preoperative symptoms included heartburn (92%), respiratory problems (42%), and dysphagia (32%). Preoperative as ...
Three types of congenital diaphragmatic hernias( Bochdalek hernia, Morgagni hernia, and esophageal hiatus hernia) are described with case presentation. In the Bochdalek hernia, the most common type of congenital diaphragmatic hernia, abdominal contents pass into the thorac bia diaphragmatic defect, limiting the space available for the developing lungs. Resulting lung hypoplasia, many infants experience severe respiratory distress within minutes of birth and may require resuscitation and stabiliz ...
A high rate of anatomical and symptomatic recurrence is frequently observed after surgical treatment of gastrooesophageal reflux, even when the classical methods described by Hill, Belsey, or Nissen are employed. A technique combining a Collis gastroplasty, which enables reconstruction of an intra-abdominal oesophageal segment, and Nissen's fundoplication, can effectively reduce the relapse rate. The various stages of the technique employed are described. ...
headings – Esophagitis, peptic. Esophageal stenosis. Models, animal. abstRact – Background Reflux esophagitis complicated by stenosis and shortening of the organ is a difficult disease to surgical treatment with frequent failure. The Collis gastroplasty associated with a partial or total fundoplication can be employed in this situation. Aim To evaluate the technique of fundoplication with partial or total Collis gastroplasty in dogs. Methods Seven dogs underwent a Collis-Lind (Group A) and f ...
BACKGROUND The aim of this study was to assess the acceptability and safety of day-case laparoscopic Nissen fundoplication for gastroesophageal reflux disease in children. METHODS All children who underwent a laparoscopic Nissen fundoplication procedure were analyzed retrospectively, and the cases who had day surgery were selected over a 2-year period (May 2003-August 2005). All patients had proven symptomatic reflux disease. Inclusion criteria were that children were over 6 months of age and ...
The role of surgical therapy in the management of gastroesophageal reflux disease (GERD) continues to evolve in the laparoscopic era. As the number of surgical procedures increases, so does the number of patients with postfundoplication complications. The most effective strategy is to prevent the complication in the first place. Patients who are most likely to have trouble after surgery are those with refractory, atypical, or complicated disease. Gastroenterologists should take care to make an a ...
OBJECTIVE To present a multicenter series of 6 patients who developed gastrobronchial fistula (GBF). GBF is a rare subtype of gastric leaks following bariatric surgery, which is the mainstay of treatment for the obesity pandemic. METHODS We retrospectively identified 6 patients with GBF (out of 2,308 cases performed: 0.2%). One patient had undergone Roux-en-Y gastric bypass, and 5 had a sleeve gastrectomy. Demographics, previous surgeries, clinical presentation, timing of fistula diagnosis, di ...
BACKGROUND The electromanometry and 24-hour esophageal pHmetry has been proposed as objective method in postoperative evaluation of antireflux surgery. AIM Prospective evaluation of the results of cruroplasty and total fundoplication in the treatment of non-complicated gastroesophageal reflux disease based on comparative results of pre and post operative manometry and pHmetry findings. METHODS Fifty-nine consecutive individuals with typical symptoms of gastroesophageal reflux disease were pr ...
OBJECTIVE To investigate late objective outcomes 14 years after laparoscopic anterior 180-degree partial versus Nissen fundoplication. BACKGROUND Clinical outcomes from randomized clinical trials suggest good outcomes for anterior 180-degree partial fundoplication, with similar control of reflux symptoms and less side effects, compared with Nissen fundoplication. However, objective outcomes at late follow-up have not been reported. METHODS A subset of participants from a randomized trial of ...
BACKGROUND Short-term outcomes of laparoscopic Heller myotomy (LHM) for achalasia have been excellent, although the long-term durability of this operation remains to be established. The aim of this study was to evaluate the long-term outcomes of LHM. METHODS A single-institution review of patients undergoing LHM between 1992 and 2003 with > or =5 years follow-up. Failure was defined as symptom recurrence requiring reoperation. Univariate and multiple regression analysis were performed to id ...
BACKGROUND/AIMS Better antacid medications and the introduction of laparoscopy destabilize the indications for fundoplication. This study aims at raising a discussion among pediatric surgeons on these indications, modalities, and the results of this operation. MATERIALS AND METHODS A total of 252 refluxing children operated between 1992 and 2006 were divided into groups according to predominant symptoms (93 digestive, 47 respiratory, and 68 neurologic) or to comorbidities (27 esophageal atresi ...
From January 1992 to July 1993, 94 patients with symptomatic gastroesophageal reflux and/or hiatal hernia underwent laparoscopic Nissen-Rossetti fundoplication. The median follow-up was 4.5 months. There was no conversion to open surgery and no postoperative mortality. Laparoscopic reoperation was necessary in 2 patients haemorrhage and there were 2 cases of food impaction. 6 patients developed a chest postoperative infection. 6 cases of dysphagia extending beyond 2 months were observed. In 3 of ...