The surgical treatment of the intrathoracic migration of the gastro-oesophageal junction and of short oesophagus in gastro-oesophageal reflux disease1

Mattioli, Sandro; Lugaresi, Marialuisa; Simone, Massimo Pierluigi Di; D’Ovidio, Frank; Pilotti, Vladimiro; Bassi, Francesco; Brusori, S; Gavelli, Giampaolo

doi:10.1016/j.ejcts.2004.02.009

Cited by 21 publications

(60 citation statements)

References 26 publications

(36 reference statements)

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“…Barium swallow is a very important study in the investigation and detection of postoperative complications following fundoplication. Recurrent hiatal hernia, disruption or slippage of the fundoplication, and other structural abnormalities can be identified [64]. Late postoperative dysphagia can be investigated by a combination of manometry and esophageal fluoroscopic examination.…”

Section: Diagnostic Instrumental Approachmentioning

confidence: 99%

Regurgitation in healthy and non healthy infants

Indrio

Riezzo²,

Raimondi

et al. 2009

Ital J Pediatr

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Uncomplicate regurgitation in otherwise healthy infants is not a disease. It consists of milk flow from mouth during or after feeding. Common causes include overfeeding, air swallowed during feeding, crying or coughing; physical exam is normal and weight gain is adequate. History and physical exam are diagnostic, and conservative therapy is recommended. Pathologic gastroesophageal reflux or gastroesophageal reflux disease refers to infants with regurgitation and vomiting associated with poor weight gain, respiratory symptoms, esophagitis. Reflux episodes occur most often during transient relaxations of the lower esophageal sphincter unaccompanied by swallowing, which permit gastric content to flow into the esophagus. A minor proportion of reflux episodes occurs when the lower esophageal sphincter fails to increase pressure during a sudden increase in intraabdominal pressure or when lower esophageal sphincter resting pressure is chronically reduced. Alterations in several protective mechanisms allow physiologic reflux to become gastroesophageal reflux disease; diagnostic approach is both clinical and instrumental: radiological series are useful to exclude anatomic abnormalities; pH-testing evaluates the quantity, frequency and duration of the acid reflux episodes; endoscopy and biopsy are performed in the case of esophagitis. Therapy with H2 receptor antagonists and proton pump inhibitors are suggested.

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Section: Diagnostic Instrumental Approachmentioning

confidence: 99%

Regurgitation in healthy and non healthy infants

Indrio

Riezzo²,

Raimondi

et al. 2009

Ital J Pediatr

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“…To address this issue Collis gastroplasty with fundoplication was first introduced in 1957 [6] and is the standard surgical procedure for GERD complicated by a short esophagus (SE). Initially described via a thoracotomy it has been subsequently adopted using minimally invasive techniques [19,29]. The presence of SE and the need for Collis gastroplasty has been questioned by some authorities [15].…”

Section: Discussionmentioning

confidence: 99%

Preoperative predictability of the short esophagus: endoscopic criteria

et al. 2008

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“…We considered patients who were referred to the Center for the Study and Therapy of the Diseases of the Esophagus (Surgical section) of the University of Bologna between 1980 and 2008 with a chief complaint of typical and atypical GE reflux symptoms or because surgical therapy for GERD and/or complicated hiatus hernia 7 was indicated. Since the mid‐1970s, a database was set up to investigate prospectively the pathophysiology of esophageal diseases and the outcomes of surgical therapy 8 .…”

Section: Methodsmentioning

confidence: 99%

“…Endoscopy of the upper digestive tract was performed with fiber optic endoscopes under local anesthesia and under pharmacological sedation in a few cases. In 1980, the Savary–Miller classification of esophagitis was adopted at our center 7 . In the 1990s, we switched to the Los Angeles classification 9 .…”

Section: Methodsmentioning

confidence: 99%

Prevalence and clinical picture of gastroesophageal prolapse in gastroesophageal reflux disease

Aramini

Mattioli

Lugaresi

et al. 2011

Diseases of the Esophagus

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The prevalence of gastroesophageal (GE) mucosal prolapse in patients with gastroesophageal reflux disease (GERD) was investigated as well as the clinical profile and treatment outcome of these patients. Of the patients who were referred to our service between 1980 and 2008, those patients who received a complete diagnostic work-up, and were successively treated and followed up at our center with interviews, radiology studies, endoscopy, and, when indicated, esophageal manometry and pH recording were selected. The prevalence of GE prolapse in GERD patients was 13.5% (70/516) (40 males and 30 females with a median age of 48, interquartile range 38-57). All patients had dysphagia and reflux symptoms, and 98% (69/70) had epigastric or retrosternal pain. Belching decreased the intensity or resolved the pain in 70% (49/70) of the cases, gross esophagitis was documented in 90% (63/70) of the cases, and hiatus hernias were observed in 62% (43/70) of the cases. GE prolapse in GERD patients was accompanied by more severe pain (P < 0.05) usually associated with belching, more severe esophagitis, and dysphagia (P < 0.05). A fundoplication was offered to 100% of the patients and was accepted by 56% (39/70) (median follow up 60 months, interquartile range 54-72), which included two Collis-Nissen techniques for true short esophagus. Patients who did not accept surgery were medically treated (median follow up 60 months, interquartile range 21-72). Persistent pain was reported in 98% (30/31) of medical cases, belching was reported in 45% (14/31), and GERD symptoms and esophagitis were reported in 81% (25/31). After surgery, pain was resolved in 98% (38/39) of the operative cases, and 79% (31/39) of them were free of GERD symptoms and esophagitis. GE prolapse has a relatively low prevalence in GERD patients. It is characterized by epigastric or retrosternal pain, and the need to belch to attenuate or resolve the pain. The pain is allegedly a result of the mechanical consequences of prolapse of the gastric mucosa into the esophagus.

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The surgical treatment of the intrathoracic migration of the gastro-oesophageal junction and of short oesophagus in gastro-oesophageal reflux disease1

Abstract: In surgery for severe GORD, the Collis procedure is required in 23% of operations; radiology helps to plan surgery; intraoperative endoscopy avoids unnecessary oesophageal lengthening.

Cited by 21 publications

References 26 publications

Regurgitation in healthy and non healthy infants

Regurgitation in healthy and non healthy infants

Preoperative predictability of the short esophagus: endoscopic criteria

Prevalence and clinical picture of gastroesophageal prolapse in gastroesophageal reflux disease

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