Reoperationen nach der Fundoplicatio nach Nissen

Черноусов, А. Ф.; Korchak, A. M.; Stepankin, S. N.

doi:10.1007/bf01263211

Cited by 2 publications

(3 citation statements)

References 18 publications

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“…Because of the long-term side effects of the Angelchik device as a foreign body [22], however, we generally no longer recommend it even though no complications occurred in these 2 cases up to now. Reported 30-day hospital mortality is between 0 and 17.6% [2,3,[5][6][7][8]; in our series, mortality was 2.0% (1/50). In a study of 61 patients undergoing repeated antireflux procedures after various primary procedures, Little and coworkers [6] found that mortality and morbidity increase when the number of prior operations increases.…”

Section: Discussionsupporting

confidence: 37%

“…Despite the frequent use of the Nissen fundoplication [1] as an antireflux procedure, relatively few publications have dealt with patients requiring reoperation following failed fundoplication [2][3][4][5][6][7][8][9][10]. The aim of this report is to review our experience with 50 patients reoperated for failed fundoplication of a total of 86 reoperations for failed antireflux procedures.…”

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confidence: 99%

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Reoperation following failed fundoplication

1989

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Fifty patients reoperated for failed Nissen fundoplication are presented; 29 patients (group 2) were operated between 1983 and 1988 while 21 patients (group 1) were operated before 1983. In group 1, the "slipped Nissen" had been the most frequent cause of reoperation (48%). In group 2, the most frequent causes for the unsuccessful operation were: (1) partial or total disruption of the fundic wrap (62%), (2) slipping of the fundoplication, giving rise to the telescope phenomenon (21%), and (3) creation of a fundoplication which was too low (10%). Refundoplication was performed in cases where the dissection of the previously formed fundic wrap was possible (42/50 = 84%). In group 1, three patients were treated by resection of the cardia, one by an Angelchik prosthesis and one by a distal gastric resection with Roux-en-Y diversion. In group 2, fundectomy was performed in one patient; in another, an Angelchik device was inserted, and in a third patient, fundoplication and proximal gastric vagotomy were performed. The results were excellent or good in 66% of patients in group 1 and in 76% of group 2. Operative mortality was 2% and morbidity, 4%. In conclusion, repeat fundoplication is recommended when reestablishment of the fundic region anatomy is possible during dissection. The operation can usually be performed through an abdominal route. Meticulous preoperative evaluation of the patients including 24-hour pH measurement and manometry is necessary. Good results of refundoplication should be expected in 66%-76% of patients with recurrent disease.

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Section: Discussionsupporting

confidence: 37%

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confidence: 99%

Reoperation following failed fundoplication

1989

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“…The incidence of pathological stages of the artifi cial esophagus after different replacement surgeries varies in a wide range and constitutes 23-26% [6].…”

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confidence: 99%

Cell Reorganization in Gastric Transplant during Esophagoplasty

et al. 2011

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We studied peculiarities of cell reorganization of the gastric transplant during the delayed period after esophagoplasty for benign pathologies of the esophagus. Polymorphism of adaptive and pathological structural rearrangements in the mucosa of the gastric tube was observed. Degenerative and atrophic changes in epithelial structures, hypertrophy of smooth muscular components, and sclerotic reorganization of the stroma were predominating morphological phenomena. Heterogeneity of ultrastructural modifications of the epithelium reflected high secretory activity of foveal mucocytes in combination with degenerative changes in cytoplasmic organelles and impaired secretory function of fundic gland cells. Hypertrophied cells with minor ultrastructural changes, leiomyocytes with signs of biosynthesis, and degenerated smooth muscle fibers were revealed in the population of smooth muscle cells.

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Reoperationen nach der Fundoplicatio nach Nissen

Cited by 2 publications

References 18 publications

Reoperation following failed fundoplication

Reoperation following failed fundoplication

Cell Reorganization in Gastric Transplant during Esophagoplasty

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