Vázquez SMAJH, Castañeda RCA, Martínez FL, Arenas EG, Ayala ZJ, Padilla AJM

Language: Spanish
References: 14
Page: 30-35
PDF size: 50.97 Kb.

ABSTRACT

Gastroesophageal reflux (GER), the most common esophageal pathology in which the inferior esophageal sphincter is involved. This chronic pathology has a large impact on quality of life, and this provokes an important question, “Have we been diagnosing GER in more patients or has its frequency been increasing?” Recent studies in the United States have shown that GER is prevalence in 25 to 35% of the population. The diagnosis is made clinically and confirmed by endoscopy, treatment includes weight-reduction, modification of food intake as well as lifestyle. Medical treatment is by way of a Proton Blocking Pump and prokinetics. There are certain indications for performing the surgery. Laparoscopy has shown better results and a shorter period of recovery. GER has a multifaceted etiology, the acid and alkali that erode the esophageal mucous, abnormalities in the defense mechanism, esophageal motility disorder, gastric emptying and the inferior esophageal sphincter are the main causes. The role of bile reflux from the duodenum is under investigation in differents countries. In recent U.S. studies, more than 60% of the patients with GER also have alkaline reflux, and as we know, the association of both refluxes makes the treatment more difficult. This study presents our experiences in the treatment of 493 cases with GER, the diagnostic procedures, the surgeries performed and the accompanying results. We included only the cases that were handled by the same surgical team.

REFERENCES

1. Dallemagne B, Weerts JM, Jehaes C, Mrkiewics S, Lombard R. Laparoscopic Nissen Fundoplication preliminary report. Surg Laparosc Endosc 1999; 1: 138-143.

2. Chousleb A, Suchleib S, Heredia N, Carrasco A, Torices E, Cervantes J, Mondragon A, Tort A. Reflujo gastroesofágico. Tratamiento quirúrgico con técnicas de invasión mínima. Rev Mex de Cir Endosc 2001; 2: 47-51.

3. Hidalgo F, Melgoza C, Hesiquio S. Funduplicatura tipo Nissen por vía laparoscópica en el tratamiento de la esofagitis por reflujo. Análisis de 72 pacientes. Cirujano General 2002; 24: 3; 196-200.

4. Patti MG, Arcerito M, Feo CV, De pinto M, Tong J, Gantert W et al. An analysis of operations for gastroesofphageal reflux disease: identifying the important technical elements. RCH Surg 1998; 133: 600-7.

5. An American Gastroenterological Association medical position statement: Guidelines on the use of esophageal manometry. American Gastroenterol Association. Gastroenterology 1994; 107: 1865.

6. American Gastroenterological Association medical position statement. Guidelines on the use of esophageal pH recording. Gastroenterology 1996; 110: 1981.

7. Kahrilas PJ, Clouse RE, Hogan WJ. American Gastro Association, technical review on the clinical use of esophageal manometry. Gastroenterology 1994; 107: 1865-84.

8. Sontag S et al. Persistent gastroesophageal reflux disease symptoms on standard proton-pump inhibitor therapy. Gastroent Clin North Am 2002; 31: 577.

9. Locke G et al. Natural history of nonerosive reflux disease: Is all gastro-esophageal reflux disease the same? What is the evidence? Gastroenterol Clin North Am 2002; 31 (4 suppl): 559.

10. Ofman J et al. Decision making in Gastroesophageal disease, what are-the critical issues? Gastroenterol Clin North Am 2002; 31: 567.

11. Goldenhersh MJ et al. Asthma and Gastroesophageal reflux in infants and children. Inmunol Allergy. Clin North Am 2001; 21(3): 439-448.

12. Fass R. Gastroesophageal reflux disease revisted. Gastroent Clin North Am 2002; 31 (4 suppl): 51.

13. Waring J. Surgical and Endoscopic treatment of gastroesophageal reflux-disease. Gastroent Clin North Am 2002; 31: 589.

14. Ritter MP, Peters JH, De Meester TR, Crookes PF, Mason RJ, Green L, Bremner CG. Outcome after laparoscopic fundoplication is not dependent Upon a structurally defective lower esophageal sphincter. J Gastrountest Surg 1998; 2: 567-572.