Long-term (15-year) objective evaluation of 150 patients after laparoscopic Nissen fundoplication

Laparoscopic Nissen fundoplication is the preferred operative treatment for patients with gastroesophageal reflux disease. The most recent published results only refer to clinical evaluations and few discuss objective measurements. Our purpose was to determine the late results of laparoscopic Nissen fundoplication, performing clinical, endoscopic, histologic, and functional studies.
Source: Surgery - Category: Surgery Authors: Source Type: research

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ConclusionsGEJ opening dynamics attained by EndoFLIP appear to be associated with symptomatic outcomes. When the Dmin and CSA do not decrease by a defined threshold, heartburn is more likely to be severe at 6 or more months postoperatively. This suggests that the fundoplication may not be tight enough to prevent persistent or recurrent GERD.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
CONCLUSION: LVG mildly increases GER, which is likely related to the development of hiatal hernias and a decrease in LES pressure and esophageal sweep. However, LVG should not be contraindicated for patients with preoperative pH-metric GER, as this may clear after the procedure. PMID: 31257899 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
Laparoscopic anti-reflux surgery (LARS) utilizing fundoplication plays a major role in the treatment of gastroesophageal reflux disease (GERD). It is important to consider that long term control of reflux in the patient with obesity has been shown to be worse (failure up to four times more likely) than in normal weight patients following Nissen fundoplication. Recurrence of symptoms after LARS may benefit from medical management in some cases, while in others revisional surgery should be considered.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
The effect of laparoscopic fundoplication on reflux-related chronic cough is unpredictable, the aim of the study is to investigate the predictive effect of positive reflux-cough correlation on the resolution o...
Source: BMC Gastroenterology - Category: Gastroenterology Authors: Tags: Research article Source Type: research
Purpose of review The purpose of this review is to discuss the efficacy, morbidity and side-effects of innovative management strategies for achalasia that include high-resolution manometry (HRM), pneumatic dilatation, laparoscopic Heller's myotomy (LHM), injection of botulinum toxin into the lower esophageal sphincter and peroral endoscopic myotomy (POEM). Recent findings HRM has enabled identification of achalasia subtypes that have important prognostic implications. Pneumatic dilatation is a commonly-used and cost-effective method of treating achalasia but has shown poor longevity of symptom relief compared with oth...
Source: Current Opinion in Gastroenterology - Category: Gastroenterology Tags: ESOPHAGUS: Edited by Stuart J. Spechler Source Type: research
Conclusion: GORD symptoms improve for most patients' 1-year post-operatively. A small proportion of patients will develop troublesome GORD, but overall satisfaction remains high.
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
Introduction: Laparoscopic sleeve gastrectomy (LSG) is one of the surgical procedures indicated in the treatment of obesity. The occurrence of gastroesophageal reflux (GER) in the postoperative period of this surgery is related to a reduction in the lower esophageal sphincter (LES) tone and the presence of gastric residual fundus (RF) associated with increased gastric intraluminal pressure. Fixation of the remaining gastric reservoir to the gastrosplenic and gastrocolic ligaments (omentopexy) has emerged as a technical option to avoid or decrease GER in the postoperative period of LSG. Objective: To evaluate the prese...
Source: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques - Category: Surgery Tags: Original Articles Source Type: research
To verify the results of the treatment of post-operative giant hiatal hernia (POGH). The POGH becomes each time more frequent after surgical treatment of the gastroesophageal reflux. Fifteen patients (6 females and 9 males; 43.66 ± 5.05 years old; BMI 22.13 ± 1.92) were referred to our Service, for surgical treatment of a type III POGH 30.4 ± 1.76 months after treatment of gastroesophageal reflux disease. The need for a reoperation was determined mainly by dysphagia. Reoperation was completed laparoscopically in all patients and the mean postoperative hospital stay was 3.2 ± 1...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Per-oral Endoscopic Myotomy (POEM) for Achalasia is associated with a short-term clinical response of 82-100%. In comparison to the historical gold standard Laparoscopic Heller Myotomy (LHM), POEM is as effective in short term, with a favorable safety profile and less invasive nature. The drawback of POEM is the higher incidence of reflux disease compared to LHM with fundoplication (39% vs 16.8%). There is a real clinical need to address GERD and esophagitis after POEM. We previously performed in canines an anterior approach POEM followed by a trans-oral incisionless fundoplication (TIF) in the same session.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Oral abstract Source Type: research
Conditions:   GERD;   Reflux, Gastroesophageal;   Surgery Intervention:   Procedure: Anti-reflux surgery Sponsors:   University of Southern Denmark;   Sygehus Lillebaelt;   Odense Patient Data Explorative Network Enrolling by invitation
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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