Subject(s)
Endoscopic Mucosal Resection , Neoplasms , Stomach Neoplasms , Humans , Traction , Stomach/surgery , Gastroscopy , Suture Techniques , Stomach Neoplasms/surgeryABSTRACT
PURPOSE: Although laparoscopic Nissen fundoplication (LNF) is a kind of minimally invasive surgery, some transition time may still be required to allow the fundoplicated stomach to adapt to the new anatomical position. We observed transient delayed gastric emptying (DGE) post-LNF in our preliminary study. This study aimed to investigate the occurrence rate and development of transient DGE post-LNF. METHODS: Patients who underwent LNF for gastroesophageal reflux disease (GERD) at our institution were recruited consecutively. They were treated with standardized LNF and prospectively followed up for 2 months. Proper diet guidance and/or pharmacologic therapy were given during these 2 months. GERD Health-Related Quality of Life (GERD-HRQL), DGE symptoms, and DGE status were evaluated preoperatively and postoperatively. RESULTS: Fifty-one patients underwent LNF and completed a 2-month follow-up. LNF succeeded in all patients. Prior to LNF, no DGE was identified. At the 1-month follow-up, LNF led to a significant reduction in the GERD-HRQL total score but a significantly increased DGE score. Endoscopically, DGE was identified in forty-seven (n = 47, 92.2%) patients. At the 2-month follow-up, the GERD-HRQL scores continued to show decreases compared to the 1 month. The DGE score returned to the baseline value. Endoscopically, no DGE was identified in any patients (n = 0, 0.0%). CONCLUSIONS: Transient DGE is a very common one-month post-LNF but can recover quickly in the second month following LNF.
Subject(s)
Gastroesophageal Reflux , Gastroparesis , Laparoscopy , Fundoplication , Gastroesophageal Reflux/surgery , Humans , Quality of Life , Treatment OutcomeABSTRACT
To compare the Stretta procedure with proton pump inhibitors for the treatment of nonerosive reflux disease (NERD).From July 2018 to April 2019, patients diagnosed with NERD and referred for treatment were enrolled. They were treated with either Stretta procedure or proton pump inhibitor (PPI) medication and followed-up for 6 months. The symptom control, quality of life, lower esophageal sphincter (LES) pressure, 24-hour pH parameters, PPI usage and satisfaction rate were evaluated. The complications were assessed. The outcomes of the 2 groups were analyzed and compared.Twenty-eight patients in the Stretta group and 21 patients in the PPI group completed the 6-month follow-up. No severe adverse events occurred in both groups. Both interventions were effective in improvement of symptom and quality of life. The symptom score improvement was significantly superior in the Stretta group compared to the PPI group (6.3â±â3.4 vs 8.5â±â4.1, Pâ=â.03). LES pressure increased significantly in the Stretta group compared to the PPI group (14.2â±â4.4 mm Hg vs 10.0â±â4.0 mm Hg, Pâ<â.01). Although both interventions improved 24-hour pH parameters, including number of acid episodes (Pâ=â.27), acid exposure time (Pâ=â.39), and DeMeester score (Pâ=â.28), no difference was found between the 2 groups. Complete PPI cessation rate (82% vs 52%, Pâ=â.03) as well as satisfaction rate (89% vs 57%, Pâ=â.02) was much higher in Stretta group than those in the PPI groupThe Stretta procedure was safe and effective in the short term for the management of NERD. The Stretta procedure resulted in higher LES pressure and achieved better improvement of symptom control and PPI cessation than did PPI in the short term.
Subject(s)
Catheter Ablation/methods , Gastroesophageal Reflux/therapy , Proton Pump Inhibitors/therapeutic use , Adult , Catheter Ablation/adverse effects , Esophageal Sphincter, Lower/physiopathology , Female , Follow-Up Studies , Humans , Hydrogen-Ion Concentration , Male , Middle Aged , Patient Satisfaction , Proton Pump Inhibitors/adverse effects , Quality of LifeABSTRACT
The religiosity of people describing themselves as 'nonbelievers' was explored in a Chinese sample. 578 students (310 women, 268 men; M age = 23.5 yr., SD = 3.3) participated in the study. The extent of religious beliefs was measured by the Religiosity subscale of the Social Axiom Survey (SAS). The results indicated that while nonbelievers generally neither believed nor disbelieved in the existence of a supreme being, they did believe that religion has some positive effects-providing a meaning to life as well as helping to keep moral standards. Religiosity in China seems to be a continuous and pluralized construct rather than a dichotomous concept.
