ABSTRACT
Spontaneous rupture of the esophagus, Boerhaave syndrome, is a rare pathology and emergency condition for the patient. Patient, 63-year-old, on the 6th day of the disease falls into the clinic, where a Boerhaave syndrome was diagnosed. Laparoscopic surgery was performed. Sanitation and drainage of the mediastinum, suturing of the perforation hole were performed. After the operation, а positive response to treatment was observed. A group of authors believes that a minimally invasive approach to the treatment of spontaneous esophageal rupture is the alternative method for patients with severe somatic status and a small perforated opening of the esophagus.
ABSTRACT
BACKGROUND/AIMS: Although laparoscopic fundoplication is a well-established therapy for gastroesophageal reflux disease (GERD) in Western countries, the mainstay of GERD treatment in Korea is long-term proton pump inhibitor (PPI) use. The aim of the present study was to evaluate nationwide data regarding antireflux surgery in Korea. METHODS: Data from 2011 to 2014 were collected from the Korean Antireflux Surgery Study Group and then analyzed. RESULTS: A total of 87 patients underwent laparoscopic fundoplication for the treatment of GERD. Preoperatively, typical symptoms were present in 81 patients (93%) and atypical symptoms were present in 51 patients (59%). Twenty-seven patients (31%) had poor PPI responses. The average surgical time and postoperative hospital stay were 116.3±42.3 minutes and 4.3±3.1 days, respectively. At 3 months after surgery, typical symptoms were completely controlled in 86.3% of patients and partially controlled in 11.7%, whereas atypical symptoms were completely controlled in 63.3% of patients and partially controlled in 23.3%. CONCLUSIONS: This study showed that although atypical symptoms and PPI nonresponders are common, the complete control rates of typical and atypical symptoms were 86.3% and 63.3%, respectively. Laparoscopic fundoplication is an efficacious method of controlling the symptoms of GERD and has an acceptable rate of postoperative morbidity and adverse symptoms.
Subject(s)
Humans , Fundoplication , Gastroesophageal Reflux , Korea , Length of Stay , Methods , Operative Time , Proton Pump Inhibitors , Proton PumpsABSTRACT
La Enfermedad por Reflujo Gastroesofagico es una condición que se desarrolla debido a reflujo gástrico persistente lo cual causa alteraciones nutricionales, síntomas molestos específicos, enfermedad respiratoria secundaria y daño en la anatomía e histología del esófago. El objetivo del tratamiento quirúrgico consiste en restablecer o reforzar los mecanismos de barrera anti reflujo. Se realizó funduplicatura laparoscópica por técnica de Nissen a cuatro pacientes, con edades comprendidas entre 2 y 5 años que presentaban Enfermedad por Reflujo Gastroesofagico. Dos pacientes presentaban daño neurológico y se les realizó gastrostomía en el mismo tiempo quirúrgico, formando parte éste procedimiento del abordaje laparoscópico. No se presentaron complicaciones en el post-operatorio inmediato ni mediato y todos los pacientes permanecen sin síntomas respiratorios ni gastrointestinales después de doce meses de seguimiento posterior el acto quirúrgico. La funduplicatura laparoscópica constituye una alternativa segura, provista de muchas ventajas en comparación con la cirugía abierta y debe ser el método de elección para el tratamiento de la Enfermedad por Reflujo Gastroesofagico cuando existe fracaso en el manejo medico.
The Gastroesophageal Reflux Disease is a condition that develops persistent gastric reflux causing nutritional disorders, specific troublesome symptoms, respiratory disease and secondary damage to the anatomy and histology of the esophagus. The goal of surgery is to restore or strengthen mechanisms for anti reflux barrier. Laparoscopic Nissen fundoplication was performed in four patients, aged between 2 and 5 years and who had gastroesophageal reflux disease. Two patients had neurological damage and a gastrostomy was performed during the laparoscopic procedure. No immediate and mediate complications in the postoperative period where seen, all patients remain symptom free during the twelve months of follow-up. Laparoscopic fundoplication is a safe alternative and provide many advantages over open surgery and should be the method of choice for the treatment of gastroesophageal reflux disease when there is failure of medical management.
ABSTRACT
Medical treatment so far takes the major portion in the treatment of gastroesophageal reflux disease (GERD). Histamine-2 receptor antagonists, proton pump inhibitors and antacids, which are used in the medical treatment of GERD, decreases intragastric acidity, and therefore decreases acid reflux. However, recurrences are frequently observed after the cessation of medication. On the other hand, fundoplication, the surgical management of GERD, aims for physiologic reconstruction of esophagogastric junction, and for correcting the pathogenetic cause of GERD. But fundoplication is linked to risks related to surgery and general anesthesia. Laparoscopic funcoplication minimizes these risks. We recently experienced three cases of GERD improved by laparoscopic 270o fundoplication. One patient was intolerant of long-term proton pump inhibitor treatment, and two patients had hiatal hernia, and one of them showed failure to medical treatment. This report describes these three cases with a brief review of literatures survey.