The efficacy of Heller’s esophagocardiomyotomy with Dor la esofagocardiomiotomía de Heller con funduplicatura de Dor por laparoscopia. Se realizó funduplicatura D’Or en 35 casos, Nissen en 35, Toupet en 14, cierre simple de pilares en 2, Narbona en 1 y Lortat-Jakob en 1; en 10 pacientes se. A Nissen fundoplication, or laparoscopic Nissen fundoplication when performed via In a Dor (anterior) fundoplication, the fundus is laid over the top of the.
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In all patients in our series an antireflux technique or gastropexy was associated, except in 2 patients in which simply a pillar closure was performed. Frey’s procedure Pancreas transplantation Pancreatectomy Pancreaticoduodenectomy Puestow procedure. Esophagogastroduodenoscopy Barium swallow Upper gastrointestinal series. Studies have shown that after 10 years, If postoperative gas-bloat syndrome does not resolve with time, dietary restrictions, counselling regarding aerophagia, and correction — either by endoscopic balloon dilatation [ citation needed ] or repeat surgery to revise the Nissen fundoplication to a partial fundoplication — may be necessary.
Nissen fundoplication – Wikipedia
Even though paraesophageal hernia is not frequent, it may potentially cause very serious complications. This page was last edited on 2 Novemberat Follow-up with imaging tests should be performed for an indeterminate period of time. The procedure is now routinely performed laparoscopically.
Surgical repair consists of hernia reduction and pillar closure. In a Dor anterior fundoplication, the fundus is laid over the top of the esophagus; while in a Toupet posterior fundoplication, the fundus is wrapped around the back of the esophagus.
In other projects Wikimedia Commons. Furthermore, 3 patients were reoperated because of GER symptoms. The satisfaction rate was Artificial extracorporeal liver support Bioartificial liver devices Liver dialysis Dog Liver biopsy Liver transplantation Portal hypertension Transjugular intrahepatic portosystemic shunt [TIPS] Distal splenorenal shunt procedure. Surgical procedures performed are shown in table III.
There is consensus about repairing once diagnosed, funduplicathra of whether they are symptomatic or funduplidatura 1. In GERD, it is usually performed when medical therapy has failed; but, with a Type II paraesophageal hiatus herniait is the first-line procedure. To evaluate long-term results a survey was performed between January and Aprilinquiring on recurrence and patient satisfaction.
Surg Laparosc Endosc Percutan Tech ; 16 5: The literature defines an optimal follow-up time of about 2 years for relapse control 12but in our case we found one recurrence that showed up after 5 years.
An antireflux technique is often added since there is evidence of GER symptoms when a fundoplication was not performed, even in those previously asymptomatic 8. Data were collected on age, sex, clinical signs and symptoms, diagnostic studies, surgical technique, postoperative complications, and hospital stay.
Hernia de hiato paraesofágica: cirugía laparoscópica vs. cirugía abierta
Forty-five patients reported pyrosis, 34 epigastric postprandial pain, and 15 dysphagia; eight patients were diagnosed with gastric volvulus. Open Nissen fundoplication and mesh placing was performed for the 3 patients.
Quantitative variables dlr defined by mean median in no-Gaussian variables funduplicatufa interval values; for discrete variables the number of cases and percentages were used.
During follow-up we analyzed all other 84 patients We retrospectively reviewed all patients who underwent surgery for paraesophageal hernia between and Its importance is based on the severe complications it may have, including gastric volvulus, and surgical treatment is recommended when a diagnosis is established. The procedure has borne his name since it gained popularity in the s. J Am Coll Surg ; From Wikipedia, the free encyclopedia. There was no mortality related to surgery in any of both groups.
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Despite that, 11 patients had symptoms of GER, 3 of whom required reoperation for this reason. Complications include “gas bloat syndrome”, dysphagia trouble swallowingdumping syndromeexcessive scarring, vagus nerve injury and, rarely, achalasia. Although antacids and PPI drug therapy can reduce the effects of reflux acid, successful surgical treatment has the advantage of eliminating drug side-effects and damaging effects from other components of reflux such as bile or gastric contents.
This is the reason why treatment is recommended for all caseseven if some authors question this attitude and advocate for an expecting attitude in selected cases 4,5.
Current controversies in paraeophageal hernia repair. If the symptoms warrant a repeat surgery, the surgeon may use Marlex or another form of artificial mesh to strengthen the connection. There was a statistically significant lower hospital stay in the LP group median 3.
Median hospital stay was 9. Comparison of laparoscopic versus open repair of paraesophageal hernia. A comparison of discrete variables was performed using Student’s t-method Mann-Whitney for non-normal variables.
Deceased patients and those lost to follow-up were excluded. Time between surgery and recurrence was 1, 2. Conclusion Results after laparoscopic and open surgery are equivalent in terms of efficacy and complication rates, with a significantly shorter hospital stay in the former group. An approach to the management of paraesophageal hiatus hernias. Mid term analysis of safety and quality of life after the laparoscopic repair of paraeophageal hiatal hernia. Nevertheless, some authors still recommend observation for asymptomatic cases taking as a basis a mortality rate associated with surgery that can reach 5.
Material and methods We retrospectively reviewed all patients who underwent surgery for paraesophageal hernia between and