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Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2008, Number 1

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Rev Esp Med Quir 2008; 13 (1)

Laparoscopic treatment in patients with gastroesophageal reflux

Aranda MM, Vargas ÁAL, Castro MA, Palacio VF, Aranda PJC

Language: Spanish
References: 12
Page: 24-27
PDF size: 207.29 Kb.


ABSTRACT

Objective: To communicate the results of laparoscopic and open surgery in a regional hospital during four years.
Material and methods: A retrospective study where we included patients that were operated with laparoscopic fundoplication from May 1st 2002 to May 1st 2006. The variables were: intraoperative complications, conversion to laparotomy and most common postoperative complications.
Results: Were registered 138 patients, 55.1% women and 44.9% men, with 1 to 80 years old, median of 46 years ± 14.8. Were made 100% of endoscopy preoperative and oesophageal biopsy; 58% had esophagitis grade III, 19.6% IV, 13.8% II and 8.7% grade I; 7.2% with Barrett’s esophagus, hiatal hernia in 14.5%, and 2.2% with achalasia. Were carried out preoperative 24-hour pH monitoring and manometer in 58% and 83.3% respectively; 88.4% were refractory to the medical antirreflux treatment. 12.3% needed laparotomy; 2.17% presented intraoperative complications and 10.9% had postoperative complications. Seven patients were carried out colecistectomy; seven with vagotomy; cardiomiotomy in three patients with achalasia; two hepatic biopsy; one biliary derivation and one repair of gastric perforation.
Conclusions: Every year of surgical practice the frequency conversion to laparotomy was less, with p ‹0.05.


REFERENCES

  1. Seely AJE, Sundaresan RS, Finley RJ. Principles of laparoscopic surgery of the gastroesophageal junction. J Am Coll Surg 2005;200(1):77-87.

  2. Bowrey DJ, Peters JH. Cirugía laparoscópica del esófago. Clínicas Quirúrgicas de Norteamérica 2000;4:1263-94.

  3. Chousleb A, Shuchleib S, Heredia N, et al. Reflujo gastroesofágico. Tratamiento quirúrgico con técnicas de invasión mínima. Rev Mex Cir Endoscop 2001;2(2):47-51.

  4. Gurski RR, Peters JH, Hagen JA, et al. Barrett’s esophagus can and does regress after antireflux surgery: A study of prevalence and predictive features. J Am Coll Surg 2003;196(5):706-12.

  5. Morales-Conde S, Morales-Méndez S. Tratamiento laparoscópico del reflujo gastroesofágico. En: Tratamiento por vía laparoscópica de la enfermedad por reflujo gastroesofáfico. Guía Clínica de Cirugía Endoscópica. Madrid: Editorial Elba, 1998;pp:305-15.

  6. Derick JC, Buyske J. Current status of antireflux surgery. Surg Clin North Am 2005;85(5):931-47.

  7. DeMeester TR, Stein HJ. Minimizing the side effects of antireflux surgery. World J Surg 1992;16:335-6.

  8. Power C, Maguire D, McAnena O. Factors contributing to failure of laparoscopic Nissen fundoplication and the predictive value of preoperative assessment. Am J Surg 2004;187(4):457-63.

  9. Gómez CX, Flores AJH, Di Martino AE, Guarneros ZJE, Cervera SA y col. Resultados a largo plazo entre dos técnicas laparoscópicas antirreflujo. Rev Mex Cir Endoscop 2004;5(3):121-6.

  10. Ahlberg G, Kruuna O, Leijonmarck CE, OvasKa J, et al. Is the learning curve for laparoscopic fundoplication determined by the teacher or the pupil? Am J Surg 2005;189(2):184-9.

  11. Hwang H, Turner LJ, Blair NP. Examining the learning curve of laparoscopic fundoplications at an urban community hospital. Am J Surg 2005;189(5):522-6.

  12. Mehran A, Allen C. Five-year comprehensive outcomes evaluation in 181 patients after laparoscopic Nissen fundoplication. J Am Coll Surg 2003;196(1):51-59.




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