Does the nissen fundoplication procedure improve esophageal dysmotility in patients with barrett's esophagus?

Autor:	FalcÃo AM; - Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, São Paulo - SP - Brasil.; - Universidade Federal de Pernambuco, Faculdade de Medicina, Departamento de Cirurgia, Recife - PE - Brasil., Nasi A; - Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, São Paulo - SP - Brasil., Szachnowicz S; - Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, São Paulo - SP - Brasil., Santa-Cruz F; - Universidade Federal de Pernambuco, Faculdade de Medicina, Recife - PE - Brasil., Seguro FCBC; - Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, São Paulo - SP - Brasil., Sena BF; - Departamento de Epidemiologia, Escola de Saúde Pública T.H. Chan de Harvard, Boston - MA - EUA., Duarte A; - Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, São Paulo - SP - Brasil., Sallum RA; - Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, São Paulo - SP - Brasil., Cecconello I; - Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, São Paulo - SP - Brasil.
Jazyk:	English; Portuguese
Zdroj:	Revista do Colegio Brasileiro de Cirurgioes [Rev Col Bras Cir] 2020 Nov 30; Vol. 47, pp. e20202637. Date of Electronic Publication: 2020 Nov 30 (Print Publication: 2020).
DOI:	10.1590/0100-6991e-20202637
Abstrakt:	Objective: to evaluate esophageal dysmotility (ED) and the extent of Barrett's esophagus (BE) before and after laparoscopic Nissen fundoplication (LNF) in patients previously diagnosed with BE and ED. Methods: twenty-two patients with BE diagnosed by upper gastrointestinal (GI) endoscopy with biopsies and ED diagnosed by conventional esophageal manometry (CEM) were submitted to a LNF, and followed up with clinical evaluations, upper GI endoscopy with biopsies and CEM, for a minimum of 12 months after the surgical procedure. Results: : sixteen patients were male (72.7%) and six were females (27.3%). The mean age was 55.14 (± 15.52) years old. and the mean postoperative follow-up was 26.2 months. The upper GI endoscopy showed that the mean length of BE was 4.09 cm preoperatively and 3.91cm postoperatively (p=0.042). The evaluation of esophageal dysmotility through conventional manometry showed that: the preoperative median of the lower esophageal sphincter resting pressure (LESRP) was 9.15 mmHg and 13.2 mmHg postoperatively (p=0.006). The preoperative median of the esophageal contraction amplitude was 47.85 mmHg, and 57.50 mmHg postoperatively (p=0.408). Preoperative evaluation of esophageal peristalsis showed that 13.6% of the sample presented diffuse esophageal spasm and 9.1% ineffective esophageal motility. In the postoperative, 4.5% of patients had diffuse esophageal spasm, 13.6% of aperistalsis and 22.7% of ineffective motor activity (p=0.133). Conclusion: LNF decreased the BE extension, increased the LES resting pressure, and increased the amplitude of the distal esophageal contraction; however, it was unable to improve ED.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu