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Добірка наукової літератури з теми "Laparoscopic fundoplication"

Автор: Grafiati
Опубліковано: 10 грудня 2022
Оновлено: 28 січня 2023

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Статті в журналах з теми "Laparoscopic fundoplication"

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Cowgill, Sarah M., Rachel Gillman, Emily Kraemer, Sam Al-Saadi, Desiree Villadolid, and Alexander Rosemurgy. "Ten-Year Follow up after Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease." American Surgeon 73, no. 8 (August 2007): 748–53. http://dx.doi.org/10.1177/000313480707300803.

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Анотація:
Laparoscopic Nissen fundoplication was first undertaken in the early 1990s. Appreciable numbers of patients with 10-year follow up are only now available. This study assesses long-term outcome and durability of outcome after laparoscopic Nissen fundoplication for treatment of gastro-esophageal reflux disease. Since 1991, 829 patients have undergone laparoscopic fundoplications and are prospectively followed. Two hundred thirty-nine patients, 44 per cent male, with a median age of 53 years (± 15 standard deviation) underwent laparoscopic Nissen fundoplications at least 10 years ago; 28 (12%) patients were “redo” fundoplications. Before and after fundoplication, among many symptoms, patients scored the frequency and severity of dysphagia, chest pain, vomiting, regurgitation, choking, and heartburn using a Likert scale (0 = never/not bothersome to 10 = always/very bothersome). Symptom scores before versus after fundoplication were compared using a Wilcoxon matched-pairs test. Data are reported as median, mean ± standard deviation, when appropriate. After fundoplication, length of stay was 2 days, 3 days ± 4.8. Intra-operative inadvertent events were uncommon and without sequela: 1 esophagotomy, 1 gastrotomy, 3 cardiac dysrhythmias, and 3 CO2 pneumothoraces. Complications after fundoplication included: 1 postpneumonic empyema, 3 urinary retentions, 2 superficial wound infections, 1 urinary tract infection, 1 ileus, and 1 intraabdominal abscess. There were two perioperative deaths; 88 per cent of the patients are still alive. After laparoscopic Nissen fundoplication, frequency and severity scores dramatically improved for all symptoms queried (P < 0.001), especially for heartburn frequency (8, 8 ± 3.2 versus 2, 3 ± 2.8, P < 0.001) and severity (10, 8 ± 2.9 versus 1, 2 ± 2.5, P < 0.001). Eighty per cent of patients rate their symptoms as almost completely resolved or greatly improved, and 85 per cent note they would again have the laparoscopic fundoplication as a result of analysis of our initial experience, thereby promoting superior outcomes in the future. Nonetheless, follow up at 10 years and beyond of our initial experience documents that laparoscopic fundoplication durably provides high patient satisfaction resulting from long-term amelioration of the frequency and severity of symptoms of gastroesophageal reflux disease. These results promote further application of laparoscopic Nissen fundoplication.
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Sadowitz, Benjamin D., Kenneth Luberice, Ty A. Bowman, Alexandra M. Viso, Daniel E. Ayala, Sharona B. Ross, and Alexander S. Rosemurgy. "A Single Institutions First 100 Patients Undergoing Laparoscopic Anti-Reflux Fundoplications: Where are They 20 Years Later?" American Surgeon 81, no. 8 (August 2015): 791–97. http://dx.doi.org/10.1177/000313481508100817.

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Анотація:
Although anti-reflux surgery has been used liberally over the past decades for the treatment of gastroesophageal reflux disease (GERD), few studies report follow-up after 10 years. This study was undertaken to report follow-up on 100 consecutive GERD patients up to 22 years after utilizing a laparoscopic fundoplication. Hundred consecutive patients undergoing laparoscopic fundoplication for GERD were prospectively followed beginning in 1992. The frequency and severity of symptoms before and after laparoscopic fundoplication were scored on a Likert scale (1 = never/none to 10 = always/very bothersome). Median data are reported. Of the 100 patients who underwent laparoscopic fundoplication for their GERD, nine were reoperations. Twenty-six patients are deceased on average 11 years after their fundoplications. Seventy-four patients are alive, with 27 patients, actively followed for 19 years after their fundoplications. At most recent follow-up, patients experienced long-term amelioration of symptom frequency and severity after fundoplication (e.g., heartburn frequency = 8–2, severity = 8–1; P < 0.01 for each). Eighty-four per cent of patients rated their symptom frequency as less than once per month. Eighty-eight per cent of patients were satisfied with their postoperative results, and 95 per cent of patients confirmed they would have the operation again knowing what they know now. Long-term follow-up documents high patient satisfaction and durable symptomatic relief up to two decades after laparoscopic fundoplication for GERD. Patients should seek this operation not only for symptomatic relief, but to mitigate the deleterious effects of long-term acid exposure and anti-acid therapy.
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Tan, Sanda, and Mark L. Wulkan. "Minimally Invasive Surgical Techniques in Reoperative Surgery for Gastroesophageal Reflux Disease in Infants and Children." American Surgeon 68, no. 11 (November 2002): 989–92. http://dx.doi.org/10.1177/000313480206801110.

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Анотація:
Fundoplication is commonly performed in children suffering from complications of gastroesophageal reflux disease (GERD). Recently laparoscopic fundoplication has become a standard of care for GERD in children. Published reports show that 2.3 to 14 per cent of children require reoperation after failed fundoplication. The purpose of this study is to show the feasibility of minimally invasive surgical (MIS) techniques to treat children after failed fundoplication. A retrospective chart review was performed for all patients who underwent laparoscopic redo fundoplication at Children's Healthcare of Atlanta at Egleston from July 1998 to July 2000. The patients' records were reviewed for age, diagnosis, type and time of initial operation, type and time of redo operation, operative time for redo operation, and complications. Seventeen children (age 3 months to 18 years) had operations for failed fundoplication attempted using MIS techniques. Six of these children were referred after their initial operation performed elsewhere. Nine (53%) were neurologically impaired. Ten (59%) have respiratory complications of GERD. The initial procedures were as follows: One open Nissen fundoplication, two open Thal fundoplications, 13 laparoscopic Nissen fundoplications, and one laparoscopic Toupet fundoplication. The reoperative procedures performed were revision of fundoplication and hiatal hernia repair (13) or hiatal hernia repair only (four). Two patients had concurrent gastric emptying procedures. One procedure was converted to open for technical reasons. One patient developed a pelvic abscess secondary to leakage around the gastrostomy tube. One child had erosion into the esophagus of a Dacron® patch that was used to close a large hiatal defect. Thirteen patients began feeding by the first postoperative day. We conclude that MIS techniques can be applied to reoperative surgery for the treatment of GERD with an acceptable complication rate in this difficult group of patients. Reoperative patients appear to have the same benefits from MIS as patients undergoing their initial procedure.
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Cowgill, Sarah M., Dean Arnaoutakis, Desiree Villadolid, Sam Al-Saadi, Demetri Arnaoutakis, Daniel L. Molloy, Ashley Thomas, Steven Rakita, and Alexander Rosemurgy. "Results after Laparoscopic Fundoplication: Does Age Matter?" American Surgeon 72, no. 9 (September 2006): 778–84. http://dx.doi.org/10.1177/000313480607200904.

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Анотація:
Antireflux fundoplications are undertaken with hesitation in older patients because of presumed higher morbidity and poorer outcomes. This study was undertaken to determine if symptoms of gastroesophageal reflux disease (GERD) could be safely abrogated in a high-risk/reward population of older patients. One hundred eight patients more than 70 years of age (range, 70–90 years) underwent laparoscopic Nissen fundoplications undertaken between 1992 and 2005 and were compared with 108 concurrent patients less than 60 years of age (range, 18–59 years) to determine relative outcomes. Before and after fundoplication, patients scored the severity of reflux and dysphagia on a Likert Scale (0 = minor, 10 = severe). Before fundoplication, older patients had lower reflux scores ( P < 0.01), but not lower dysphagia scores or DeMeester scores. One patient (86 years old) died from myocardial infarction; otherwise, complications occurred infrequently, inconsequentially, and regardless of age. At similar durations of follow-up, reflux and dysphagia scores significantly improved ( P < 0.01) for older and younger patients. After fundoplication, older patients had lower dysphagia scores ( P < 0.01) and lower reflux scores ( P < 0.01). At the most recent follow-up, 82 per cent of older patients rated their relief of symptoms as good or excellent. Similarly, 81 per cent of the younger patients reported good or excellent results. Ninety-one per cent of patients 70 years of age or more versus 85 per cent of patients less than 60 years would undergo laparoscopic Nissen fundoplication again, if necessary. With fundoplication, symptoms of GERD improve for older and younger patients, with less symptomatic dysphagia and reflux in older patients after fundoplication. Laparoscopic fundoplication safely ameliorates symptoms of GERD in elderly patients with symptomatic outcomes superior to those seen in younger patients.
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Benkoe, Thomas M., Katrin Rezkalla, Lukas Wisgrill, and Martin L. Metzelder. "Is There a Role for Elective Early Upper Gastrointestinal Contrast Study in Neurologically Impaired Children following Laparoscopic Nissen Fundoplication?" Children 8, no. 9 (September 16, 2021): 813. http://dx.doi.org/10.3390/children8090813.

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Assessment of discomfort as a sign for early postoperative complications in neurologically impaired (NI) children is challenging. The necessity of early routine upper gastrointestinal (UGI) contrast studies following laparoscopic Nissen fundoplication in NI children is unclear. We aimed to evaluate the role of scheduled UGI contrast studies to identify early postoperative complications following laparoscopic Nissen fundoplication in NI children. Data for laparoscopic Nissen fundoplications performed in NI children between January 2004 and June 2021 were reviewed. A total of 103 patients were included, with 60 of these being boys. Mean age at initial operation was 6.51 (0.11–18.41) years. Mean body weight was 16.22 (3.3–62.5) kg. Mean duration of follow up was 4.15 (0.01–16.65 years) years. Thirteen redo fundoplications (12.5%) were performed during the follow up period; eleven had one redo and two had 2 redos. Elective postoperative UGI contrast studies were performed in 94 patients (91%). Early postoperative UGI contrast studies were able to identify only one complication: an intrathoracal wrap herniation on postoperative day five, necessitating a reoperation on day six. The use of early UGI contrast imaging following pediatric laparoscopic Nissen fundoplication is not necessary as it does not identify a significant number of acute postoperative complications requiring re-intervention.
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Spaniolas, Konstantinos, Richard I. Rothstein, and Thadeus L. Trus. "Transgastric-Assisted Endoscopic Fundoplication." Case Reports in Medicine 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/280628.

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Анотація:
Gastroesophageal reflux disease (GERD) is a common entity in the United States. Surgical fundoplication can be performed safely with well-established long-term results. In selected patients with GERD, endoluminal therapy has a potential role. We report on a patient with recurrent GERD after two prior fundoplications who wished to pursue endoscopic treatment. The presence of a gastrostomy tube allowed for the performance of a transgastric-assisted endoluminal fundoplication using the EndoCinch (TM) device and standard pediatric laparoscopic instruments. Symptomatic relief of GERD with EndoCinch (TM) is common but the long-term outcomes are limited. Nevertheless, the EndoCinch (TM) device remains a method for endoscopic suturing in certain settings. In patients with gastrostomy access, the use of laparoscopic instruments may further enable the performance of advanced endoscopic therapies.
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Ruiz-Tovar, Jaime, Maria Diez-Tabernilla, Alejandro Chames, Vicente Morales, Alfonso Sanjuanbenito, and Enrique Martinez-Molina. "Clinical Outcome at Ten Years after Laparoscopic Fundoplication: Nissen versus Toupet." American Surgeon 76, no. 12 (December 2010): 1408–11. http://dx.doi.org/10.1177/000313481007601228.

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Анотація:
Laparoscopic surgery has become the elective approach for the surgical treatment of gastroesophageal reflux disease in the last decade. Outcome data beyond 10 years are available for open fundoplication, with good-to-excellent results, but few studies report long-term follow-up after laparoscopic fundoplication. We performed a retrospective study of all the patients that underwent laparoscopic Nissen and Toupet fundoplications as antireflux surgery between 1995 and 1998 in our institution. To evaluate the long-term results, a face-to-face interview was performed in 2009. One hundred and six patients were included in the study. Surgical techniques performed were Nissen fundoplication (NF) in 56 patients and Toupet (TF) in 50. Complication rate was 4 per cent in both groups (nonsignificant [NS]). Two patients (4%) of NF required reoperation because of dysphagia. After 10 years, 10 per cent of the patients remain symptomatic in both groups. Fifteen per cent of NF take daily inhibitors of the proton pump versus 14 per cent of TF (NS). Twenty per cent of NF refer dysphagia, all of them without evidence of stenosis at endoscopy or contrasted studies. The satisfaction rate of the patients was 96 per cent in NF and 98 per cent in TF. Laparoscopic Toupet fundoplication seems to be as safe and long-term effective as Nissen, but with a lower incidence of postoperative dysphagia. In our experience Toupet fundoplication should be the elective approach for the surgical treatment of gastroesophageal reflux disease.
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Maish, Mary, and Jeffrey A. Hagen. "Laparoscopic fundoplication." Operative Techniques in Thoracic and Cardiovascular Surgery 9, no. 2 (2004): 115–28. http://dx.doi.org/10.1053/j.optechstcvs.2004.05.003.

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Georgeson, Keith E. "Laparoscopic fundoplication." Current Opinion in Pediatrics 10, no. 3 (June 1998): 318–22. http://dx.doi.org/10.1097/00008480-199806000-00018.

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MEDINA, LAURA T., RAFAEL VEINTIMILLA, MARK D. WILLIAMS, and MICHAEL E. FENOGLIO. "Laparoscopic Fundoplication." Journal of Laparoendoscopic Surgery 6, no. 4 (August 1996): 219–26. http://dx.doi.org/10.1089/lps.1996.6.219.

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Більше джерел

Дисертації з теми "Laparoscopic fundoplication"

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Khan, Mansoor Ali. "Outcomes of laparoscopic fundoplication." Thesis, University of Warwick, 2016. http://wrap.warwick.ac.uk/88019/.

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Gastro-esophageal reflux disease (GORD) is common and a variety of surgical repair techniques have been shown to be effective. This thesis contains two randomised controlled trials and a combined data analysis of both studies to establish which techniques appear the most effective in controlling reflux. It also contains a pilot study to determine whether intraoperative manometry can predict which patients are likely to suffer from postoperative dysphagia. One hundred and three underwent partial fundoplication (Anterior or Posterior) and one hundred and twenty one patients underwent total/subtotal (Nissen or Lind) in the randomised controlled trials and 40 patients were recruited into the intraoperative manometry study. Patients were followed up for 12 months and their change in symptoms recorded. In the partial fundoplication trial, patients who underwent posterior fundoplication had better control of symptoms compared to those who underwent anterior fundoplication at the 12 month follow up point. There was no difference between the groups who underwent Nissen and Lind fundoplication. When the studies were collated, the laparoscopic total/subtotal fundoplication appears to be superior in the control of reflux when compared to the laparoscopic partial fundoplication. Intraoperative manometry may be advantageous as the study does suggest that this investigation may be useful in predicting post-operative dysphagia.
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Porter, Victoria. "Long-term effectiveness of laparoscopic partial anterior fundoplication." Thesis, University of Aberdeen, 2011. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=168326.

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Анотація:
Introduction: Gastro-oesophageal disease (GORD) is a common disease affecting 20% of adults in the Western world (Dexter 2004) and occurs when the anti-reflux barrier is compromised. Anti-reflux surgery can be recommended to patients with GORD as an alternate to long-term medical therapy. Aim: Laparoscopic anterior fundoplication (LAF) is the preferred type of anti-reflux surgery in our institution. This study aimed to determine the long-term effectiveness of LAF by means of quality of life (QOL) and acid reflux level assessment. Methods: After applying exclusion criteria, patients were sent an invitation for the study along with a QOL questionnaire (QOLRAD) to complete. Selected patients were also invited to undergo 24-hour pH studies. These patients were also asked to complete another QOL questionnaire (Reflux questionnaire (RQ)). Results: QOLRAD questionnaires were analysed (n = 126) and mean scores were calculated for each dimension in addition to an overall QOL score. Over 75% of patients in both the medium-term (2-4 years) and long-term groups (5-14 years) had a good QOL (score 5-7). The median QOL score for the long-term group was 5.89 (±1.36). In addition, Reflux Questionnaire QOL scores (n = 20) (RQLS) indicated that patients were well with a median score of 87.7 out of 100 at long-term. By comparing our post-operative results to published baseline result, our patients QOL had improved since surgery. Most dimensions (QOLRAD) and all symptoms scores (RQ) suggested improvement from baseline. Post-operative 24-hour pH testing (n = 22 0) showed that 55% of patients had a normal TFT pH<4 and that a further 18% had better TFT pH <4 than pre-operatively at long-term follow-up Conclusion: This study suggests that LAF is effective in the long-term by maintaining a good QOL and controlling acid reflux levels. However, larger numbers of participants and pre-operative data are required to confirm these findings.
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Franzén, Thomas. "Success and failure of conventional and laparoscopic fundoplication in gastro-oesophageal reflux disease /." Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/med796s.pdf.

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Kuzinkovas, Vytauras. "Laparoscopic versus open nissen fundoplication in the rat : induced immunotrauma and its impact on pertoneal adhesion formation /." [S.l : s.n.], 1997. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.

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Sandbu, Rune. "A Laparoscopic Approach in Gastro-Oesophageal Surgery : Experimental and Epidemiological Studies." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2001. http://publications.uu.se/theses/91-554-5155-1/.

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Kappaz, Guilherme Tommasi. "Avaliação da qualidade de vida e fatores associados à satisfação dos pacientes submetidos ao tratamento cirúrgico da Doença do Refluxo Gastroesofágico." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/5/5168/tde-08082013-152851/.

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Анотація:
Introdução: O tratamento cirúrgico da doença do refluxo gastroesofágico (DRGE) possui excelente resultado na maioria dos pacientes. Porém, um grupo significante de indivíduos apresenta complicações ou recidiva dos sintomas, com impacto na qualidade de vida. Objetivos: Avaliar o grau de satisfação dos pacientes submetidos à fundoplicatura laparoscópica à Nissen, e comparar os resultados da aplicação do questionário GERD-HRQL de qualidade de vida pessoalmente e por via telefônica. Identificar fatores pré e pós-operatórios associados ao resultado do tratamento cirúrgico. Métodos: Foram selecionados 178 pacientes operados entre 2005 e 2009, no serviço de cirurgia do esôfago do HCFMUSP. Os pacientes foram convocados para consulta ambulatorial. Foram levantados os prontuários médicos para obtenção de dados pré-operatórios. No estudo foi feita a análise de dados epidemiológicos, cirúrgicos, endoscópicos e manométricos. Os pacientes foram divididos em grupos, e foi aplicado o questionário de qualidade de vida GERD- HRQL. Foi avaliada também a nota de melhora dos sintomas de 0 a 10, a intenção de fazer novamente a cirurgia e o uso atual de omeprazol. Os pacientes que não puderam comparecer ao ambulatório foram entrevistados por telefone. Resultados: 90 pacientes foram incluídos no estudo, 45 no grupo A (entrevista ambulatorial) e 45 no grupo B (entrevista telefônica). Houve diferença significante entre a pontuação média no questionário GERD-HRQL dos pacientes do grupo A (6,29) e B (14,09), p=0,002. Esse resultado também foi significante quando separados homens (p=0,018) e mulheres (p=0,049) de ambos os grupos. Porém, a nota de melhora dos sintomas (p=0,642) e a intenção de fazer novamente a cirurgia (p=0,714) foram iguais. Analisando-se somente os pacientes do grupo A, a correlação linear de Pearson não mostrou diferença estatística entre a pontuação no questionário GERD-HRQL e idade (p=0,953), IMC pré-operatório (p=0,607), IMC pós-operatório (p=0,498), pressão do esfíncter inferior do esôfago (PEM, p=0,651; PRM, p>0,999) e amplitude média de contração do esôfago distal (p=0,997). A correlação da pontuação média no questionário GERD-HRQL com número de pontos na hiatoplastia (p=0,857), presença de esofagite erosiva pré-operatória (p=0,867), tamanho da hérnia hiatal (p=0,867) e presença de distúrbio motor do esôfago (p=0,207) também não mostrou significância estatística. A presença de esôfago de Barrett maior que 1cm correlacionou-se com menor pontuação no questionário GERD-HRQL (p=0,035). O uso rotineiro de omeprazol foi marcador de menor satisfação com a cirurgia (p=0,034). Conclusões: A satisfação dos pacientes com o tratamento cirúrgico é de forma geral elevada. A aplicação do questionário GERD-HRQL mostrou pior qualidade-de-vida dos pacientes entrevistados por telefone, em comparação aos pacientes entrevistados pessoalmente no ambulatório. O uso rotineiro de omeprazol após a cirurgia esteve associado à menor satisfação com o tratamento cirúrgico da DRGE Não foram identificados fatores pré-operatórios que possam determinar pior resultado da fundoplicatura laparoscópica à Nissen, porém a presença de esôfago de Barrett no pré-operatório foi um marcador de maior satisfação dos pacientes operados
Introduction: The surgical treatment of gastroesophageal reflux disease (GERD) has excellent results in most patients. However, a significant group develops complications or recurrence of symptoms, with impact on quality-of- life. Objectives: Evaluate the satisfaction of patients submitted to laparoscopic Nissen fundoplication, and compare the results of the GERD-HRQL quality of life questionnaire applied in person and by telephone. Identify pre and postoperative factors associated with the outcome of the surgical treatment.. Methods: 178 patients operated by the esophageal surgery division at Hospital das Clínicas da Faculdade de Medicina da USP, between 2005 and 2009, were selected. Patients were invited to an ambulatory interview. Charts were reviewed, and preoperative data was obtained. Epidemiological, surgical, endoscopic, and manometric parameters were studied. Patients were divided in groups, and the GERD-HRQL questionnaire was used. We also evaluated the score of symptom improvement between 0 and 10, if the patient would do the surgery again and current use of omeprazole. Patients who could not come to the ambulatory were interviewed by telephone. Results: 90 patients were enrolled in the study, 45 in group A (ambulatory interview) and 45 in group B (telephonic interview). There was significant statistical difference between the average score in the GERD-HRQL questionnaire in groups A (6,29) and B (14,09), p=0,002. This result was also significant among men (0,018) and women (0,049) in both groups. However, the score of symptom improvement (p=0,642) and the intention of doing the surgery again (p=0,714) were equivalent. In group A patients, Pearson\'s linear correlation did not show statistical difference between the GERD-HRQL score and age (p=0,953), preoperative BMI (p=0,607), postoperative BMI (p=0,997), inferior esophageal sphincter pressure (PEM, p=0,651; PRM, p>0,999) and distal esophageal contraction pressure (p=0,997). The correlation between GERD-HRQL score and number of stitches in hiatoplasty (p=0,857), presence of preoperative erosive esophagitis (p=0,867), size of hiatal hernia (p=0,867) and presence of motor esophageal disturbances (p=0,207) did not show statistical significance. The presence of Barrett\'s esophagus larger than 1cm correlated with a lower score on GERD-HRQL questionnaire (p=0,035). The routine use of omeprazole was a marker of lower satisfaction with the surgical treatment (p=0,034). Conclusions: Patient satisfaction with surgical treatment is generally high. The GERD-HRQL questionnaire showed poorer quality-of-life of patients interviewed by telephone, compared to patients interviewed at the ambulatory. The routine use of omeprazole after surgery was associated with lower satisfaction with the surgical treatment. No preoperative factors were identified that could determine worst outcome after laparoscopic Nissen fundoplication, but the presence of Barrett\'s esophagus preoperatively was a marker of increased patient\'s satisfaction
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Ahlberg, Gunnar. "The role of simulation technology for skills acquisition in image guided surgery /." Stockholm : Department of Surgical Sciences, Karolinska institutet, 2005. http://diss.kib.ki.se/2005/91-7140-331-0/.

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8

Pinheiro, Fernando Antonio Siqueira. "Comparative clinical study between conventional esofagocardiomiotomia of heller associated cardiopexia hill and anterior fundoplication pain with esofagocardiomiotomia of heller isolated held by video-laparoscopy in the surgical treatment of achalasia." Universidade Federal do CearÃ, 1998. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=10396.

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Анотація:
Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico
The aim of this study is to evaluate the use of the Heller esophagocardiomyotomy (HECM) in the megaesophagus surgical treatment comparing the HECM associated with the Hill cardiopexy (HCP) and the Dor anterior fundoplication (DAFP). with the isolated HECM performed through videolaparoscopy (VL). Ninety patients with achalasic or chagasic megaesophagus, 1, II or III degrees, were analysed and operated in the Digestive Surgery Serviee at the Ãdouard Herriot hospital of the Claude Bernard University, Lyon-France, in the Walter CantÃdeo University Hospital at the Medicine School of the Federal University of Cearà and in the General Surgery Service of the Dr. Josà Frota Institute Hospital, Fortaleza-CearÃ, from january, 1981, to november, 1996. Fifty-nine patients (Group 1) submitted to lhe HECM associated to the HCP and the DAFP were analysed in a retrospective study. From those, 45.76% were men, 54.24% were women, and the average age was 44.86 +/- 1.91 years. Thirty-one patients (Group 2) submitted to the isolated HECM carried out through VL were studied prospectively. 41.94% of the patients were men and 58.06% were women, with the average age of 46.6l +/- 3.09 years. Both groups were analysed by evaluating the thecnical and tactical aspects of the operations, as well as, the clinical and functional results ( radiologic study of the esophagus, manometry and esophageal pHimetry ). The operation was technically feasible in all the patients of Group 1 and in 30 patients of Group 2, occuring, in this group, the only conversion case into laparotomy due lo an esophagic mucosa perforation. There were 10.16% of complications in Group 1 (3 mucosa perfurations, 1 left subfrenic abscess, 1 right frenic nerve paralysis. 1 abdominal wall infection and 6.4% in Group 2 (2 mucosa perforations). The mortality was none in both groups. The patients submitted to the isolated HECM performed through VL showed signifÃcantly more satisfactory results as the regards the surgical time analyses, the oral diet start and the hospital stay. The radiologic study presented a light decrease of the esophagic caliber in 59.3% of the Group 1 patients and 54.8% of the Group 2 patients. At the esophageal manometry, the HECM ( isolated or associated with HCP and the DAFP ) produces a significative decrease of the lower esophageal sphincter pressure (LESP), dropping from 6.48 kPa to 1.61 kPa in Group 1 (p<0.01) and from 5.57 kPa to 1.23 kPa in Group 2 (p<0.01). The postoperative LESP showed to be significantly higher in the patients submitted to the HECM associated with the HCP and the DAFP than in those submitted to the isolated HECM, 1,61 kpa 1,23 kPa respectively (p<0.05). The esophageal pHmetry presented low reflux rates in both groups 12.35% in Group 1 and 11.54% in Group 2). The clinical evaluation detected good results in 86.20%, of the Group 1 patients and in 89.65% of the Group 2 patients. In Group 1, 10.34% showed a regular result (4 with minor esophagitis and 2 with occasional dysphagia) and 3.45% showed a relapsing result. In Group 2, 10.35% presented a regular result (1 with minor esophagitis and 2 with occasional dysphagia). The average follow-up of these patients was 41.68 months in Group 1 and 20.24 months in Group 2.
Este estudo tem como objetivo avaliar o emprego da esofagocardiomiotomia de HelIer ( ECMH ) no tratamento cirÃrgico do megaesÃfago, comparando a ECMH associada à cardiopexia de Hill ( CPH ) e fundoplicatura anterior de Dor ( FPAD ) realizada por laparotomia, com a ECMH isolada realizada por vÃdeoÂ-laparoscopia ( VL). Foram analisados 96 pacientes, portadores de megaesÃfago acalÃsico ou chagÃsico. graus I, II ou III, operados no ServiÃo de Cirurgia Digestiva do Hospital Ãdouard HÃrriot da Universidade Claude Bernard, Lyon-FranÃa, no Hospital UniversitÃrio Walter CantÃdeo da Faculdade de Medicina da UFC e no ServiÃo de Cirurgia Geral do Hospital Instituto Dr. Josà Frota, Fortaleza-CearÃ, no perÃodo de janeiro de 1981 à novembro de 1996. CinqÃenta e nove pacientes ( Grupo 1 ) submetidos a ECMH associada à CPH e FPAD foram analisados em um estudo retrospectivo. Destes, 45,76% eram do sexo masculino, 54.24% do sexo feminino, e a mÃdia da idade era de 44,86 +/-1,91 anos. Trinta e um pacientes ( Grupo 2 ) submetidos a ECMH isolada por VI, foram estudados prospectivamente. 41,94% dos pacientes eram do sexo masculino e 58,06% do sexo feminino, com a mÃdia da idade de 46,61 Â/- 3,09 anos. Os dois grupos foram analisados avaliando os aspectos tÃcnicos e tÃticos das operaÃÃes, assim como, os resultados clÃnicos e funcionais ( estudo radiolÃgico do esÃfago, manometria e pHmetria esofagiana). A operaÃÃo foi tecnicamente factÃvel em todos os pacientes do Grupo 1 e em 30 pacientes do Grupo 2, ocorrendo, neste grupo, um Ãnico caso de conversÃo para laparotomia devido a uma perfuraÃÃo de mucosa esofÃgica. Houve 10,16% de complicaÃÃes no Grupo 1 ( 3 perfuraÃÃes de mucosa, 1 abscesso sub-frÃnico esquerdo, 1 paralisia do nervo frÃnico direito, 1 infecÃÃo de parede ) e 6,4% no Grupo 2 ( 2 perfuraÃÃes de mucosa ). A mortalidade foi nula em ambos os grupos. Os pacientes submetidos a ECMH isolada realizada por VL apresentaram resultados significativamente mais satisfatÃrios no que diz respeito a anÃlise do tempo cirÃrgico, do inÃcio da dieta oral e da permanÃncia hospitalar. O estudo radiolÃgico mostrou uma leve diminuiÃÃo do calibre esofÃgico em 59,3% dos pacientes do Grupo 1 e em 54,8% dos pacientes do Grupo 2. à manometria esofagiana, a ECMH (isolada ou associada à CPH e FPAD) produz uma diminuiÃÃo significativa da PEIE, caindo de 6,48 kPa para 1,61 Kpa no Grupo 1 ( p<0,01 ) e de 5,57 kPa para 1,23 kPa no Grupo 2 ( p-<0,01 ). A PEIE pÃs-operatÃria mostrou-se significativamente mais elevada nos pacientes submetidos a ECMH associada à CPH e FPAD) do que naqueles submetidos a ECMH isolada, 1,61 kPa e 1,23 kPa respectivamente ( p<0,05). A pHmetria esofagiana mostrou baixos Ãndices de refluxo em ambos os grupos (12,25% no Grupo 1 e 11,54% no Grupo 2). A avaliaÃÃo clÃnica constatou bons resultados em 86,20% dos pacientes do Grupo 1 e em 89,65% dos pacientes do Grupo 2. No Grupo 1, 10.34% apresentaram resultado regular ( 4 com esofagite leve e 2 com disfagia ocasional ) e 3,45% recidiva. No Grupo 2, 10,35% apresentaram resultado regular (1 com esofagite leve e 2 com disfagia ocasional). O seguimento mÃdio destes pacientes foi de 41,68 meses no Grupo 1 e de 20,24 meses no Grupo 2.
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9

Myers, Jennifer C. "Risk and pathogenesis of dysphagia related to antireflux surgery." Thesis, 2016. http://hdl.handle.net/2440/105023.

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Dysphagia, the difficulty of swallowing food or drink, is experienced by some patients with gastro-oesophageal reflux disease and is a common adverse effect of antireflux surgery, a procedure involving diaphragmatic hiatal repair and fundoplication. Dysphagia after surgery in the absence of recognisable anatomical abnormalities is poorly understood and thus difficult to treat. Despite modifications to surgical techniques, post-operative dysphagia remains unpredictable (Chapter 1). My aim is to identify patients at risk and the causes of dysphagia related to antireflux surgery. A fundamental premise of this thesis is that objective measurements hold the key to understanding post-fundoplication dysphagia. Five prospective studies are presented which evaluate oesophageal body or oesophago-gastric junction (OGJ) function with regards to: early new-onset and late persistent post-operative dysphagia. Objective data were gathered using: i) luminal manometry alone; ii) impedance combined with manometry, to assess relationships between oesophageal pressure and bolus flow; and iii) three-dimensional pressure recordings of expiratory and inspiratory radial OGJ pressure to assess the contribution of hiatal repair and fundoplication to post-operative dysphagia. These studies show: an ‘oesophageal ileus’ in the early post-operative period, with global failure of primary peristalsis in 70% of patients after total fundoplication, compared with 20% of patients after cholecystectomy. Oesophageal ileus is transient with subsequent return of preoperative motility patterns (Chapter 2). Of all patients undergoing laparoscopic antireflux surgery in the Unit (tertiary care hospital), the incidence of late revisional surgery is low at 5.6%, including 3% for persistent dysphagia. Dysphagia is the most common indication for revisional surgery, albeit with lower patient satisfaction with outcome than revisional surgery for recurrent reflux (Chapter 3). In addition, flawed interaction between oesophageal and OGJ function is implicated in dysphagia. OGJ resistance to outflow is associated with dysphagia when there is sub-optimal distal oesophageal contractile strength and relatively high OGJ relaxation pressure on swallowing (Chapter 4). Limited tools for impedance-manometry data analysis inspired the conceptualisation and development of new automated combined pressure-flow analysis, achieved through scientific collaboration. This novel approach revealed for the first time that some patients have a pre-existing, asymptomatic, subtle variation of viscous bolus compression and movement in relation to oesophageal peristalsis that increases the risk of new-onset postoperative dysphagia (Chapter 5). Fundoplication and hiatal repair alter OGJ anatomy to prevent reflux. However, after surgery, aberrant asymmetry of radial OGJ pressure during inspiration is associated with persistent dysphagia, consistent with a focally restrictive diaphragmatic hiatus from crural repair (Chapter 6). In conclusion, oesophageal ileus in the early post-operative period is transient and the rate of late revisional surgery for troublesome dysphagia is low. Post-surgical dysphagia is related to a pre-existing pattern of sub-optimal bolus transport; and after surgery, inadequate modulation of oesophageal function in response to altered OGJ function. When antireflux surgery results in abnormally skewed OGJ pressures, dysphagia may be due to a ‘snug’ hiatal repair. Future studies hold promise for a reduction in post-surgical dysphagia through examination of local intrinsic modulation of swallowing function and development of objective calibration of hiatal repair.
Thesis (Ph.D.) (Research by Publication) -- University of Adelaide, School of Medicine, 2016.
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Книги з теми "Laparoscopic fundoplication"

1

König, Matthias W., and John J. McAuliffe. Difficult Ventilation During Laparoscopic Fundoplication. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199764495.003.0023.

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An ever-increasing number of surgical procedures are now performed via the laparoscopic approach, and it is estimated that about 60% of abdominal surgeries in children can be performed laparoscopically today. The creation of a pneumoperitoneum has significant effects on the respiratory system, particularly in small children. Further, laparoscopic procedures have the potential for unique complications not typically seen with conventional “open” surgical techniques.
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2

Kwon, Rachel J. Laparoscopic Nissen Fundoplication for GERD. Edited by Danny Sherwinter and Miguel A. Burch. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199384075.003.0037.

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This chapter provides a summary of a landmark study in minimally invasive surgery. How does laparoscopic Nissen fundoplication compare to an open surgical procedure in patients with gastroesophageal reflux disease with respect to reflux symptoms and reoperation rates? Starting with that question, it describes the basics of the study, including funding, year study began, year study was published, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case on laparoscopic Nissen fundoplication.
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3

Laparoscopic Fundoplication: Nissen and Toupet Techniques: Laparoscopic Surgical Series. Lippincott Williams & Wilkins, 1997.

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4

Rawat, S., L. Horgan, and C. M. S. Royston. Laparoscopic surgery. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780198510567.003.0009.

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Laparoscopic staging for abdominal malignancies 324Laparoscopic splenectomy 326Laparoscopic inguinal hernia repair 328Laparoscopic Nissen fundoplication 332Laparoscopic cholecystectomy 336Laparoscopic appendicectomy 342Obesity surgery 346Laparoscopy is an effective and useful tool for the diagnosis and staging of abdominal malignancies. Staging is of paramount importance in planning treatment for localized and advanced disease. It is imperative to accurately identify those patients with a potentially resectable, localized tumour and those patients with advanced disease or distant metastasis. Despite improvements in preoperative staging with dynamic computed tomography (CT) and endoscopic ultrasonography, unexpected liver or peritoneal metastases are found in 10–20% of patients with oesophageal, gastric and pancreatic cancer. The need for laparotomy can therefore be obviated in these patients....
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5

Rosser, James. Laparoscopic Nissen Fundoplication - Patient Education Program (Yale University School of Medical Surgery Education Series). Springer, 1997.

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6

Rosser, James C. Jr. Laparoscopic Nissen Fundoplication: Surgical Procedure (Cd-Rom For Windows & Macintosh) (Yale University School of Medical Surgery Education Series). Springer, 1998.

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7

Agarwal, Anil, Neil Borley, and Greg McLatchie. Paediatric surgery. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199608911.003.0007.

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This chapter covers paediatric operations. Procedures like rigid bronchoscopy, chest drain insertion, and central venous catheter insertion are described. Common operations of abscess drainage, appendicectomy, laparoscopy, gastrostomy, circumcision, epigastric and umbilical hernia repair, external angular dermoid cyst excision, inguinal hernia, and hydrocele are all outlined. Other operations described are fundoplication, ileostomy formation, pyloromyotomy, small-bowel resection and anastomosis. Surgery for intussusception, small-bowel atresia, meconium ileus, and oesophageal atresia are included. Urological operations include orchidopexy, scrotal exploration, cystoscopy, endoscopic correction of vescico urteric reflux (VUR), insertion and removal of JJ stent, vesicostomy, suprapubic catheter insertion, nephrectomy, repair of hypospadias, bladder augmentation, and Anderson Hynes pyeloplasty.
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Частини книг з теми "Laparoscopic fundoplication"

1

Gotley, David. "Laparoscopic Toupet Fundoplication." In Fundoplication Surgery, 91–108. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-25094-6_7.

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2

Schlottmann, Francisco, Kamil Nurczyk, and Marco G. Patti. "Laparoscopic Fundoplication." In Techniques in Minimally Invasive Surgery, 3–13. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-67940-8_1.

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3

Smith, Jessica K. "Laparoscopic Nissen Fundoplication." In Operative Dictations in General and Vascular Surgery, 29–32. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-44797-1_7.

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4

Nau, Peter. "Laparoscopic Partial Fundoplication." In Operative Dictations in General and Vascular Surgery, 33–36. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-44797-1_8.

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5

Peters, J. H. "Laparoscopic Nissen’s Fundoplication." In Operative Strategies in Laparoscopic Surgery, 115–22. Berlin, Heidelberg: Springer Berlin Heidelberg, 1995. http://dx.doi.org/10.1007/978-3-642-57797-0_21.

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6

Montupet, P., G. Cargill, and J.-S. Valla. "Laparoscopic Toupet Fundoplication." In Endoscopic Surgery in Children, 174–83. Berlin, Heidelberg: Springer Berlin Heidelberg, 1999. http://dx.doi.org/10.1007/978-3-642-59873-9_19.

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7

Montorfano, Lisandro, Jihui Li, and Raul J. Rosenthal. "Laparoscopic Nissen Fundoplication." In Mental Conditioning to Perform Common Operations in General Surgery Training, 165–68. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-319-91164-9_34.

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8

Jamieson, Glyn G., and Robert Britten-Jones. "Laparoscopic Nissen fundoplication." In Surgery of the Upper Gastrointestinal Tract, 571–74. Boston, MA: Springer US, 1994. http://dx.doi.org/10.1007/978-1-4899-6621-6_67.

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9

Lim Tan, Hock, and Salvatore Cascio. "I10 Laparoscopic Fundoplication." In Basic Techniques in Pediatric Surgery, 565–68. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-20641-2_168.

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10

Scott-Conner, Carol E. H. "Laparoscopic Nissen Fundoplication." In Chassin’s Operative Strategy in General Surgery, 161–72. New York, NY: Springer New York, 2002. http://dx.doi.org/10.1007/978-0-387-22532-6_16.

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Тези доповідей конференцій з теми "Laparoscopic fundoplication"

1

Gehwolf, P., O. Renz, E. Brenner, H. Fritsch, and H. Wykypiel. "Laparoscopic fundoplication: New aspects in neural anatomy of the esophagogastric junction." In 51. Jahrestagung & 29. Fortbildungskurs der Österreichischen Gesellschaft für Gastroenterologie & Hepatologie (ÖGGH). Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0038-1654612.

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2

Subramanya, M. S., M. B. Hossain, S. Khan, B. Memon, and M. A. Memon. "Meta-analysis of laparoscopic posterior and anterior fundoplication for gastro-oesophageal reflux disease." In 2010 IEEE/ICME International Conference on Complex Medical Engineering - CME 2010. IEEE, 2010. http://dx.doi.org/10.1109/iccme.2010.5558829.

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3

Carvalho, E., P. Almeida, S. Alves, V. Antunes, and M. Gonçalves. "ESRA19-0270 Combined anesthesia for laparoscopic nissen fundoplication and surgical gastrostomy in a child with krabbe’s disease." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.185.

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4

Grosdemouge, Cristol, Peter Weyhrauch, James Niehaus, Steven Schwaitzberg, and Caroline G. L. Cao. "Design of Training Protocol for Perceptual and Technical Skills in a Minimally Invasive Surgery." In ASME 2012 11th Biennial Conference on Engineering Systems Design and Analysis. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/esda2012-82869.

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This study investigates how the technical and perceptual skills in laparoscopic surgery, typically acquired separately in the initial learning phases, can be trained together. A task analysis and cognitive task analysis were conducted using a cholecystectomy procedure and a fundoplication procedure. An experiment was conducted to examine the interaction of technical and perceptual skill learning. Subjects were divided into three groups based on order of skills training: 1) technical-perceptual-combined skills training order, 2) perceptual-technical-combined skills training order, and 3) combined skills training. After the training sessions, performance was evaluated using the combined skill. Preliminary results indicate that performance of the group trained in the combined skills condition performed equally quickly as those who trained the technical and perceptual skills separately first. In addition, the number of technical errors and perceptual errors committed were lower. This suggests that surgical skills training may be more efficient if perceptual learning is combined with motor skills during the initial phases of training. This has implications for the design of surgical training simulators and surgical education in general.
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5

Grajales-Figueroa, G., LR Valdovinos-Garcia, LE Zamora-Nava, MA Valdovinos-Diaz, E. Coss-Adame, G. Torres-Villalobos, and F. Valdovinos-Andraca. "ENDOSCOPIC PERORAL MYOTOMY (POEM) VS LAPAROSCOPIC HELLER MYOTOMY WITH FUNDOPLICATION (MHLF) FOR THE TREATMENT OF ACHALASIA IN A TERTIARY MEXICAN CENTER." In ESGE Days 2018 accepted abstracts. Georg Thieme Verlag KG, 2018. http://dx.doi.org/10.1055/s-0038-1637434.

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6

Temiño López-Jurado, R., R. Turró Arau, J. Osorio Aguilar, M. Martí Ragué, M. Rosinach Ribera, B. González Suárez, M. Ble Caso, A. Ortega Sabater, and J. C. Espinós Pérez. "TRANSORAL INCISIONLESS FUNDOPLICATION WITH ESOPHYX-Z 2.0 FOR THE TREATMENT OF GASTROESOPHAGEAL REFLUX AFTER LAPAROSCOPIC HERNIA REPAIR (CTIF). FIRST PROCEDURE IN EUROPE." In ESGE Days 2022. Georg Thieme Verlag KG, 2022. http://dx.doi.org/10.1055/s-0042-1745125.

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