Hidalgo CF, Melgoza OC, Hesiquio SR

Language: Spanish
References: 10
Page: 196-200
PDF size: 55.38 Kb.

ABSTRACT

Objective: To analyze retrospectively a group of patients with reflux esophagitis, treated surgically with Nissen-type fundoplication using a laparoscopic approach.
Design: Retrospective, observational, study, without control group.
Setting: Third level health care private hospitals.
Patients and methods: We studied 72 patients in whom peptic esophagitis due to incompetence of the inferior esophageal sphincter had been demonstrated clinically and endoscopically. Criteria to indicate surgery were: persistence of symptoms despite medical treatment, need of high medication doses for prolonged time; grade III or IV esophagitis with complications, such as stenosis, ulceration or Barrett’s esophagus, and persistent respiratory symptoms as chronic laryngitis or recurrent pneumonia. All were subjected to Nissen type fundoplication. Post-operative follow-up was of 6 months to 7 years. We analyzed the following variables: gender, age, symptoms, evolution, surgical time, working performance, morbidity and mortality.
Results: Patients were 53 men (73%) and 19 women (27%). Age ranged from 23 to 74 years; 67% (48) of patients had more than two years of evolution. Regurgitation occurred in 93%, pyrosis in 30%, and dysphagia in 27%, as main esophageal symptoms.
Among those of non-esophagic origin were pharyngeal pain or ardor in 67%, morning hoarseness in 37%, dry cough in 33%, and halitosis in 13%. Endoscopy revealed grade II or III esophagitis in 68% of patients. Esophageal manometry was performed in only 13 patients, in none was the pH metered. Ninetyfive percent of the patients remained in the hospital for 24 hours after surgery and resumed normal activities between 7 to 10 days afterwards. Average surgical time was of 90 minutes. There was a 5% morbidity and 0% mortality.
Conclusion: If gastroesophagic reflux presents without other pathologies, the surgical treatment through laparoscopy using the Nissen technique is effective.

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