Reoperative laparoscopic antireflux surgery
| Autor: | Robin S. Macherey, Richard H. Maley, Michael F Szwerc, Rodney J. Landreneau, Robert J. Wiechmann, Tibetha S. Santucci |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Laparoscopic surgery
medicine.medical_specialty medicine.diagnostic_test business.industry Esophageal disease General surgery medicine.medical_treatment digestive oral and skin physiology Heartburn medicine.disease Nissen fundoplication Dysphagia digestive system diseases Surgery otorhinolaryngologic diseases medicine GERD Hernia medicine.symptom business Laparoscopy human activities |
| Zdroj: | Surgery. 126:723-729 |
| ISSN: | 0039-6060 |
| DOI: | 10.1016/s0039-6060(99)70128-5 |
| Popis: | Background: Laparoscopic antireflux surgery (LAP) is becoming increasingly used for the surgical treatment of medical recalcitrant gastroesophageal reflux disease (GERD). We sought to determine the utility of remedial LAP approaches to antireflux surgery. Methods: From March 1996 to December 1998, 15 patients underwent remedial LAP to manage medically recalcitrant recurrent GERD after LAP (n = 8) or open antireflux procedure (n = 1) and/or troublesome postfundoplication complications (dysphagia 6, gas bloat 4). The remedial LAP surgery consisted of conversion from Nissen to Toupet fundoplication to manage dysphagia or gas bloat symptoms (n = 7), revision of LAP Nissen fundoplication (n = 7) and LAP revision of a failed open Nissen fundoplication (n = 1) for recurrent reflux. Results: The remedial LAP repair was accomplished in all patients. Findings at operation included disrupted fundoplication (n = 6), incomplete or inappropriately positioned fundoplication (n = 2), paraesophageal hernia (n = 3), or a normal total fundoplication among patients with primary dysphagia (n = 4). Follow-up symptom scoring beyond 3 months of remedial surgery demonstrated a change from the preoperative mean dysphagia, heartburn, gas bloat, and regurgitation score (P |
| Databáze: | OpenAIRE |
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