Search of the surgical restitution from the esophagogastric physiology in gastroesophagic reflux disease. Prospective evaluation

Javier Benítez Beltrán; Andrés Hernández Ramírez; José María Zubirán Moreno; Benjamín Manzano S

2002, Number 4

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Rev Mex Cir Endoscop 2002; 3 (4)

Search of the surgical restitution from the esophagogastric physiology in gastroesophagic reflux disease. Prospective evaluation

Benítez BJ, Hernández RA, Zubirán MJM, Manzano SB

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Language: Spanish
References: 26
Page: 155-161
PDF size: 112.15 Kb.

ABSTRACT

From February 1998 to September 2000, forty patients (100%) were subjected to surgical restitution of the physiology of the esophagogastric union through laparoscopic fundoplicature with a single point at 360° and two points at 270°. The age of the patients oscillated between 19 and the 38 years with an average of 28.5. In all the patients the preoperative study included the clinical evaluation of Visick, radiological and manometric, with a minimum follow up of 3 months to 2 years. A hundred percent (N 40) presented pyrosis, 80% (N 32) referred pain in the epigastric, 15% (N 6) dysphagia, 20% (N 8) other symptoms. The preoperative radiological study showed gastroesophagic reflux in 100% of the patients. The preoperative manometries reported pressure of the inferior esophagic sphincter under 10 mmHg in 100% (N 40). The preoperative endoscopic findings were: hiatus hernia smaller than 5 centimeters (N 28), esophagitis Grade III-IV 85% (N 34) and Barret esophagus 7.5% (N 3). The Visick I clinical evaluation was done quarterly. The postoperative radiological study showed no evidence of gastroesophagic reflux. Endoscopically, there was a regression of the esophagitis. Postoperative manometries found inferior esophagic sphincter pressures between 15 and 22 mmHg 92.5% (N 37) and between 11 and 14 mmHg 7.5% (N 3). Conclusion: The search for an universal and rational procedure that restores the physiology of the esophagogastric union, within the reach of any surgeon, is perhaps the combination of actually accepted fundoplicature techniques.

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