Chousleb A, Shuchleib s, Heredia n, Carrasco A, Torices E, Cervantes J, Mondragón A, Tort A

Language: Spanish
References: 22
Page: 47-51
PDF size: 41.29 Kb.

ABSTRACT

This is retrospective study of 504 patients with pathologic gastroesophageal reflux disease (GERD) operated from june 1992 to december 1999. All patients had clinical evaluation, upper GI series and endoscopy; 268 (53.17%) had manometry and 173 (34.32%) had also pH studies. There were 257 female and 247 males, ranging in age from 1 to 82 years old (average 42). The degree of esophagitis was grade IV in 112 patients (22.22%), grade III in 273 (54.17%), grade II in 107 (54.17% and grade I in 12 cases, 73 of them had Barrett’s esophagus proven by biopsy. The time of symptoms was from 10 months to 33 years (average 2 years). Indications for surgery were: failure of medical treatment 362 (71.83%), Barrett’s esophagus 73 (14.48%), esophageal stricture 18 (3.57%), broncoaspiration 33 (6.55%), parahiatal hernia 17 (3.37%), gastric volvulos 1 (0.20%). Surgical procedures: Rossetti modification of Nissen 300 (59.52%), Toupet 139 (27.58%), Nissen 64 (12.70%), Dor 1 (0.20%). Associated procedures: Cholecystectomy 49 (9.72%), vagotomy 15 (2.98%), other procedures 49 (9.72%). Conversion rate: 18 patients (3.33%). Complications: 3 perforation esophageal, 2 gastric laceration, 1 splenic laceration, 1 patient with a nasogastric tube to anchor to the fundoplication, transient dysphagia 53 patients (10.52%), All required open correction. Transient dysphagia: 53 patients (10.52%) from 1 to 4 weeks, 10 of them required dilatation. Hospital stay: 459 patients (91.07%) 2 days, 21 patients (4.76%) 3 days. Mortality: one patient due to pulmonary thromboembolism. Excellent results in 419 patients (83.14%), good in 74 patients (14.68%), bad in 11 patients (2.18%). Conclusion: Laparoscopic fundoplication is an excellent therapeutic modality to control esophageal reflux disease with all the benefits of minimally invasive surgery, low morbidity and mortality

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