Esophageal body function in patients with paraesophageal hernia is similar to those with gastroesophageal reflux disease

2000 ◽  
Vol 118 (4) ◽  
pp. A1033
Author(s):  
Stephen B. Archer ◽  
C. Daniel Smith ◽  
Gene Branum ◽  
Kathy Galloway ◽  
Patrick Waring ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Paraesophageal Hernia ◽  
Esophageal Body ◽  
Body Function

Minimally Invasive Esophageal Procedures

2020 ◽  
Author(s):  
Jon O. Wee
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Minimally Invasive ◽  
Reflux Disease ◽  
Paraesophageal Hernia ◽  
Nissen Fundoplication ◽  
Gastroesophageal Junction ◽  
Outcome Evaluation ◽  
Barrett Esophagus ◽  
Asymptomatic Patients

In most instances, laparoscopy has replaced open procedures as the standard of care. Nevertheless, equipoise remains in the literature regarding the benefits of surgery compared with alternative treatment strategies such as medications in the case of gastroesophageal reflux disease (GERD) or endoscopic procedures in the case of achalasia. According to Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) guidelines published in 2010, indications for surgery include (1) failure of medical management, (2) patient preference, (3) complications of GERD (Barrett esophagus, peptic stricture), and (4) extraesophageal manifestations (asthma, hoarseness, cough, chest pain, aspiration). This chapter is organized by surgical procedure, all of which are derivatives of the laparoscopic Nissen fundoplication. In this chapter, the authors focus on minimally invasive surgical approaches to the treatment of the following benign esophageal disorders: GERD, achalasia, and paraesophageal hernias. New in this chapter is the in-depth coverage of laparoscopic paraesophageal hernia repair. The majority of patients with paraesophageal hernias are asymptomatic, and their hernias are found incidentally with a retrocardiac gastric bubble on an upright chest x-ray or herniated gastroesophageal junction seen on a chest or abdominal computed tomographic scan. For patients who are symptomatic, surgical repair is indicated as there is no medical treatment for this mechanical problem. For asymptomatic patients, clinical judgment needs to be used. All surgical procedures are covered by preoperative evaluation, operative planning, and operative technique, with a troubleshooting note for every step. Procedure complications, postoperative care, and outcome evaluation follow each procedure, listing the most current reports and data. This review contains 10 figures, 9 tables and 49 references Keywords: Minimally invasive surgery, esophagectomy, myotomy, gastroesophageal reflux disease, Barrett esophagus, Nissen fundoplication, fundoplication, paraesophageal hernia

scholarly journals ACIDIC AND NEUTRAL LIQUID INGESTION IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE

2014 ◽  
Vol 51 (3) ◽  
pp. 217-220 ◽  
Author(s):  
Dafne Calsoni GOMES ◽  
Roberto Oliveira DANTAS
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Healthy Volunteers ◽  
Reflux Disease ◽  
Lemon Juice ◽  
Esophageal Transit ◽  
Esophageal Body ◽  
Water Ph ◽  
Liquid Bolus ◽  
Sour Bolus

Context Sour acidic liquid has a slower distal esophageal transit than a neutral liquid. Our hypothesis was that an acidic sour bolus has a different ingestion dynamic than a neutral bolus. Method In 50 healthy volunteers and 29 patients with gastroesophageal reflux disease (GERD), we evaluated the ingestion dynamics of 100 mL of acidic sour liquid (concentrated lemon juice, pH: 3.0) and 100 mL of water (pH: 6.8). The time to ingest the total volume, the number of swallows to ingest the volume, the interval between swallows, the flux of ingestion and the volume ingested in each swallow was measured. Results In both groups, healthy volunteers and patients in treatment for GERD, the acidic liquid took longer to be ingested, a higher number of swallows, a slower flux of ingestion and a smaller volume in each swallow than the neutral bolus. There was no difference between healthy volunteers and patients with GERD. The ingestion in women was longer than in men for acidic and neutral liquids. Conclusion Acidic liquid has a different dynamic of ingestion than the neutral liquid, which may be consequence of the slower transit through the distal esophageal body or an anticipation to drink a sour bolus. Patients with GERD have the same prolonged ingestion of the acidic liquid bolus as seen in healthy volunteers.

Robotic Fundoplication for Gastroesophageal Reflux Disease and Hiatal Hernia: Initial Experience and Outcome

2018 ◽  
Vol 84 (12) ◽  
pp. 1945-1950 ◽  
Author(s):  
Massimo Arcerito ◽  
Eric Changchien ◽  
Monica Falcon ◽  
Mauricio A. Parga ◽  
Oscar Bernal ◽  
...  
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Hiatal Hernia ◽  
Reflux Disease ◽  
Paraesophageal Hernia ◽  
Surgeon Experience ◽  
Sliding Hiatal Hernia ◽  
Common Clinical Presentation ◽  
Paraesophageal Hiatal Hernia ◽  
The Mean

Gastroesophageal reflux disease, associated with sliding or large paraesophageal hiatal hernia, represents a common clinical presentation. The repair of large paraesophageal hiatal hernias is still a challenge in minimally invasive surgery. Between March 2014 and August 2016, 50 patients (18 males and 32 females) underwent robotic fundoplication (17 sliding and 33 paraesophageal hernias). The mean age of the patients was 58 years. Biosynthetic mesh was used in 28 patients with paraesophageal hernia. The mean operative time was 115 minutes (90–132) in the sliding hiatal hernia group, whereas it was 200 minutes (180–210) in the paraesophageal hiatal hernia group. The mean hospital stay was 36 hours (24–96). Eight patients experienced mild dysphagia which resolved after four weeks. No postoperative dysphagia was recorded at 30-month median follow-up. We experienced one recurrence in the sliding hernia group and two recurrences in the paraesophageal hernia group, with two patients treated robotically. Robotic fundoplication in treating sliding hiatal hernia is feasible and safe but is more challenging in the large paraesophageal group. Improved patient outcomes hinge on the operative technique used and increasing surgeon experience. The increased dexterity that robotic surgery affords enables the esophageal surgeon to more adeptly apply the traditional principles of laparoscopic fundoplication.

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