ArticleWideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques2015
Incidence of true short esophagus among patients submitted to laparoscopic Nissen fundoplication.
Article in Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionThe last two decades have observed development of surgical treatment of benign conditions of the gastroesophageal junction (GEJ), including anti-reflux surgery, due to the growing popularity of the laparoscopic approach. Migration of the fundoplication band and recurrent hiatal hernia are a result of the lack of correct diagnosis and appropriate management of the so-called short esophagus. According to various authors, short esophagus is present in up to 60% of patients qualified for anti-reflux surgery. However, some researchers question the existence of this condition.
aimTo analyze the prevalence of short esophagus in patients subjected to laparoscopic Nissen fundoplication. MATERIAL AND
methodsThe study included 202 patients who were subjected to laparoscopic Nissen fundoplication.
resultsAs many as 96% of the patients qualified for the surgical treatment showed supradiaphragmatic location of the high pressure zone. The extent of GEJ protrusion ranged from 0 cm to 3 cm (mean: 2 cm). The extent of dissection within the mediastinum was determined by the level of GEJ protrusion, and ranged from 5 cm to 12 cm (mean: 6 cm). Upon complete mobilization of the esophagus within the mediastinum, no cases of significantly shortened esophagus, precluding downward retraction of at least a 2.5-cm segment below the diaphragmatic crura, were documented. Therefore, none of the patients required Collis gastroplasty.
conclusionsThe presence of "true" short esophagus is a sporadic finding among patients qualified for anti-reflux surgery. Mediastinal dissection of the esophagus and its mobilization at an appropriate, individually defined level seems a sufficient treatment in the vast majority of these patients.
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