Background: Purpose of this study is to present the long term results of the thoracoscopic Collis laparoscopic Nissen performed for the treatment of severe GERD associated with short esophagus. Methods: GERD patients were assessed before surgery with interview based on semi-quantitative scales for grading of symptoms, esophagitis from 0 (no symptoms and esophagitis) to 3 (severe symptoms and esophagitis), global evaluation (excellent, good, fair, insuffi cient), endoscopy hysthology, barium swallow, manometry; after surgery every year, alternating interview and tests (same questionnaires as above) except routine manometry, according to a protocol. Intraoperatively the length of the addominal esophagus after maximal mediastinal mobilization of the esophagus was measured with a validated technique; true short esophagus was diagnosed when the submerged segment was 1.5 cm. After surgery, result in patients receiving medical therapy or with recurrent hernia, although asymptomatic, was classifi ed as insuffi cient. Results: From 1996 to 2011, 299 minimally invasive procedures for GERD were performed. In 62/299 (20.7 %) short esophagus was assessed. The left thoracoscopic Collis gastroplasty was associated with 1 Toupet and 1 Dor (motility disorders), with the Nissen fl oppy fundusplication in 60 patients (24 women, 36 men, mean age 55.2 13.7 years, range 20 - 77). 5 procedures were converted at the beginning of the experience. Mortality was 1.7% (1/60), morbidity 11.7% (7/60). The mean follow-up was 58.6 32.1 months (range 12–108). Discussion: With the thoracoscopic Collis-laparoscopic Nissen in patients affected by severe GERD and true short esophagus , satisfactory long-term results were achieved in 93.4% of cases. Disclosure: All authors have declared no confl icts of interest.

Long term Results of the Thoracoscopic Collis-Laparoscopic Nissen for the Treatment of severe GERD with Acquired Short Esophagus..

PERRONE, OTTORINO;LUGARESI, MARIALUISA;RUFFATO, ALBERTO;ARAMINI, BEATRICE;MATTIOLI, SANDRO
2012

Abstract

Background: Purpose of this study is to present the long term results of the thoracoscopic Collis laparoscopic Nissen performed for the treatment of severe GERD associated with short esophagus. Methods: GERD patients were assessed before surgery with interview based on semi-quantitative scales for grading of symptoms, esophagitis from 0 (no symptoms and esophagitis) to 3 (severe symptoms and esophagitis), global evaluation (excellent, good, fair, insuffi cient), endoscopy hysthology, barium swallow, manometry; after surgery every year, alternating interview and tests (same questionnaires as above) except routine manometry, according to a protocol. Intraoperatively the length of the addominal esophagus after maximal mediastinal mobilization of the esophagus was measured with a validated technique; true short esophagus was diagnosed when the submerged segment was 1.5 cm. After surgery, result in patients receiving medical therapy or with recurrent hernia, although asymptomatic, was classifi ed as insuffi cient. Results: From 1996 to 2011, 299 minimally invasive procedures for GERD were performed. In 62/299 (20.7 %) short esophagus was assessed. The left thoracoscopic Collis gastroplasty was associated with 1 Toupet and 1 Dor (motility disorders), with the Nissen fl oppy fundusplication in 60 patients (24 women, 36 men, mean age 55.2 13.7 years, range 20 - 77). 5 procedures were converted at the beginning of the experience. Mortality was 1.7% (1/60), morbidity 11.7% (7/60). The mean follow-up was 58.6 32.1 months (range 12–108). Discussion: With the thoracoscopic Collis-laparoscopic Nissen in patients affected by severe GERD and true short esophagus , satisfactory long-term results were achieved in 93.4% of cases. Disclosure: All authors have declared no confl icts of interest.
2012
Perrone O; Lugaresi M; Ruffato A; Aramini B; Mattioli S.
File in questo prodotto:
Eventuali allegati, non sono esposti

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/128699
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact