Acute Complications of Anti-Reflux Surgery

Genio, Gianmattia del; Collard, Jean-Marie

doi:10.1007/1-84628-011-7_6

Cited by 8 publications

(16 citation statements)

References 53 publications

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“…This is consistent with the statement that postoperative persistent dysphagia is multifactorial and is more likely to be sustained by an incorrect surgery (e.g. excessively narrow hiatoplasty, a misplaced or too long a wrap, slipped fundoplication, or postoperative paraesophageal hernia) [14] . We speculate that if confirmed by additional investigators, our data may represent an objective argument when considering the type of fundoplication to be used to treat gastroesophageal reflux disease.…”

Section: Discussionsupporting

confidence: 91%

Total Fundoplication Does Not Obstruct the Esophageal Secondary Peristalsis: Investigation with Pre- and Postoperative 24-Hour pH-Multichannel Intraluminal Impedance

Genio

Tolone²,

Rossetti³

et al. 2007

Eur Surg Res

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Aim: To determine the impact of total fundoplication on the spontaneous esophageal clearance, known as secondary peristalsis. Background: Although there is general agreement that total fundoplication is not an obstacle to bolus swallowing (primary peristalsis), whether it is an obstacle to spontaneous esophageal clearance (secondary peristalsis) is still not clear. Based on 24-hour monitoring, multichannel intraluminal impedance was used to calculate the time of spontaneous bolus clearance (BCT). Methods: Mean BCT was prospectively calculated in 15 consecutive patients before and after total fundoplication. BCT was calculated in seconds including all the gastroesophageal reflux episodes, whereas bolus swallows (solid meals and liquid swallows) were excluded from the analysis. Results: BCT was extrapolated from 1,057 episodes in the 623 h of study. Overall, BCT did not change after surgery (13.6 ± 4 vs. 15.2 ± 10 s; p = nonsignificant) and in the upright (12.2 ± 3 vs. 16.5 ± 7 s; p = nonsignificant) and recumbent position (22.9 ± 9 vs. 23.0 ± 9 s; p = nonsignificant). Conclusions: In this study total fundoplication did not affect the BCT by combined 24-hour ph monitoring and multichannel intraluminal impedance.

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Section: Discussionsupporting

confidence: 91%

Total Fundoplication Does Not Obstruct the Esophageal Secondary Peristalsis: Investigation with Pre- and Postoperative 24-Hour pH-Multichannel Intraluminal Impedance

Genio

Tolone²,

Rossetti³

et al. 2007

Eur Surg Res

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“…However, a common mechanism of failure after primary repair is herniation of the fundoplication wrap into the chest or the accidental transposition of the gastric fundus alongside the fundoplication. This typically results from breakdown of the hiatoplasty [16]. These postoperative complications have been reported in 23 and 42% of postsurgical patients in studies conducted by Hogan et al [34] and Altorki et al [5], respectively.…”

Section: Treatmentmentioning

confidence: 97%

Hiatal hernias

et al. 2011

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Esophageal hiatal hernias have been reported to affect anywhere from 10 to 50% of the population. Hiatal hernias are characterized by a protrusion of the stomach into the thoracic cavity through a widening of the right crus of the diaphragm. There are four types of esophageal hiatal hernias: sliding (type I), paraesophageal (type II), and combined (type III), which include elements of types I and II, and giant paraesophageal (type IV). Each type may present with different symptoms and complications. The potential severity of symptoms necessitates proper and prompt diagnosis. Diagnosis is established with the use of barium swallow on chest radiographs. Treatment for sliding hernias involves laparoscopic fundoplication. The aim of our paper is to review the extensive literature regarding hiatal hernias in an effort to enhance awareness and diagnosis of this pathology.

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“…However, herniation of the wrap into the chest is more common after laparoscopy. This probably is because of lower postoperative adhesions, a wrongly estimated amount of tissue included when the crura were approximated, or exclusion of the subdiaphragmatic fascia from the suture bites when the operation was performed using the minimally invasive approach [7]. To prevent this complication, routine hiatoplasty has become mandatory in all laparoscopic antireflux procedures.…”

Section: Discussionmentioning

confidence: 99%

“…A sudden increase in abdominal pressure, induced by vomiting, coughing, constipation, or vigorous manual work, may push the wrap through the freshly-reconstructed hiatus [7]. The stitch perpendicular to the muscular fibers transfers the pressure onto the crural tissue, which may disrupt if the amount of bite incorporated in the suture is insufficient.…”

Section: Discussionmentioning

confidence: 99%