The gastroesophageal flap valve: in vitro and in vivo observations

Hill, Lucius D.; Kozarek, Richard A.; Kraemer, S. J. M.; Aye, Ralph W.; Mercer, C. D.; Low, Donald E.; Pope, Charles E.

doi:10.1016/s0016-5107(96)70006-8

Cited by 368 publications

(324 citation statements)

References 2 publications

Supporting

Mentioning

291

Contrasting

Unclassified

Order By: Relevance

“…The progression from normal anatomy to type I hernia was well illustrated in an analysis of "flap valve" integrity as a predictor of reflux symptoms ( Figure 7) [18]. That analysis concluded that both reflux symptoms and EGJ competence (assessed in a post mortem experiment) were directly correlated to flap valve grade.…”

Section: The Endoscopic Assessment Of Sliding Hiatus Herniamentioning

confidence: 90%

Approaches to the diagnosis and grading of hiatal hernia

Kahrilas

Kim

Pandolfino

2008

Best Practice & Research Clinical Gastroenterology

373

248

View full text Add to dashboard Cite

Hiatus hernia refers to conditions in which elements of the abdominal cavity, most commonly the stomach, herniate through the esophageal hiatus into the mediastinum. With the most common type (type I or sliding hiatus hernia) this is associated with laxity of the phrenoesophageal membrane and the gastric cardia herniates. Sliding hiatus hernia is readily diagnosed by barium swallow radiography, endoscopy, or manometry when greater than 2 cm in axial span. However, the mobility of the esophagogastric junction precludes the reliable detection of more subtle disruption by endoscopy or radiography. Detecting lesser degrees of axial separation between the lower esophageal sphincter and crural diaphragm can only be reliably accomplished with high resolution manometry, a technique that permits real time localization of these esophagogastric junction components without swallow or distention related artifact.

show abstract

Section: The Endoscopic Assessment Of Sliding Hiatus Herniamentioning

confidence: 90%

Approaches to the diagnosis and grading of hiatal hernia

Kahrilas

Kim

Pandolfino

2008

Best Practice & Research Clinical Gastroenterology

373

248

View full text Add to dashboard Cite

show abstract

“…The long-term durability of TIFs was evaluated by comparing their geometric aspects, including valve length, defined as the length (in centimeters) from the apex of the fundus to the valve lip [27], circumference, defined as the distance in degrees between the two most distant points of esophagogastric valve, as well as Hill grade [28] and adherence to the endoscope through the duration of the study using published and unpublished data from the same study [19]. A global assessment of all outcome measures was performed for each patient to determine the long-term effectiveness of TIF in curing GERD [20].…”

Section: Methodsmentioning

confidence: 99%

“…Patients (n = 14, 50% female) available at 2 years had a median age of 34 (range, 23-55) years and a median BMI of 22 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31) kg/m 2 . Patients had suffered from GERD for a median of 10 (range, 3-15) years and were on continuous daily PPI therapy for a median of 6 (range, 2-13) years before undergoing TIF.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Two-year results of a feasibility study on antireflux transoral incisionless fundoplication using EsophyX

et al. 2009

View full text Add to dashboard Cite

Background A feasibility study (n = 19) evaluated the safety and initial efficacy of transoral incisionless fundoplication (TIF) for the treatment of gastroesophageal disease (GERD). The results at 1 year (n = 17) indicated that TIF was safe and had a significant effect on reducing GERD symptoms, proton pump inhibitor (PPI) usage, acid exposure, and small hiatal hernia. This study was designed to evaluate the long-term safety and durability of TIF. Methods Fourteen patients (50% female; median age, 34 years) completed the 2-year follow-up assessment tests. Three patients were excluded from the study after 1 year because two of them underwent retreatment and one was lost to follow-up. Results At 2 years, no adverse events related to TIF were reported. A C50% improvement in GERD-HRQL scores compared with those at baseline on PPIs was sustained by 64% of patients. TIF was effective in eliminating heartburn in 93% of patients and daily PPI therapy in 71% of patients. Significantly (p \ 0.05) more patients were able to consume reflux-causing foods and maintain lifestyle activities without GERD symptoms compared with baseline on PPIs. Fundoplications were durable and maintained their geometric dimensions. TIF was effective in eliminating hiatal hernia in 60% of patients and esophagitis in 55% of patients. Global assessment of all outcomes in each patient revealed that 79% of patients experienced complete cure (29%) or remission (50%) of GERD at 2 years after TIF. Conclusion The results at 2 years supported the longterm safety and durability of TIF and its sustained effect on the elimination of heartburn, esophagitis, B2 cm hiatal hernia, and daily dependence on PPIs.

show abstract

“…Thus, the final arbitrator of reflux is the competency of the EGJ, and this is likely the explanation for the independent association of hiatus hernia and abnormal acid exposure seen in the current study. Furthermore, if the anatomy of the EGJ flap valve is maintained without axial separation of the crura and LES, theoretically an elevation of IGP will be transmitted to the intra-abdominal LES, and thus, the EGJ will remain closed (13). However, if the EGJ flap valve is obliterated, it is conceivable that elevations in IGP will augment the volume of refluxate once the EGJ is forced open.…”

mentioning

confidence: 99%

The Relationship Between Obesity and GERD: "Big or Overblown"

Pandolfino

2008

Am J Gastroenterology

View full text Add to dashboard Cite

The gastroesophageal flap valve: in vitro and in vivo observations

Cited by 368 publications

References 2 publications

Approaches to the diagnosis and grading of hiatal hernia

Approaches to the diagnosis and grading of hiatal hernia

Two-year results of a feasibility study on antireflux transoral incisionless fundoplication using EsophyX

The Relationship Between Obesity and GERD: "Big or Overblown"

Contact Info

Product

Resources

About