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Dysphagia after Laparoscopic Antireflux Surgery
Authors: Šiller Jiří | Sákra Lukáš | Havlíček Karel
Year: 2006
Type of publication: článek ve sborníku
Name of source: Sborník 2nd AsianAmerica Multispecialty Summit of Laparoscopy and Minimally Invassive Surgery
Publisher name: SLS
Place: Hawai, USA
Page from-to: xx
Titles:
Language Name Abstract Keywords
cze Dysfágie jako komplikace antirefluxní chirurgie Autoři porovnávají výsledky jednotlivých podtipů operací pro refluxní chorobu gastroduodena.
eng Dysphagia after Laparoscopic Antireflux Surgery Background: The laparoscopic fundoplication for the gastroesophageal reflux disease (GERD) is of great benefit for the patiens. However, the side effects, including dysphagia and gas bloat syndrome may develop after surgery. Persistent dysphagia occurs in 3-24% of patients after fundoplication. Method: Between 1st November 1999 to 31st December, 2004 we perfomed 73 laparoscopic fundoplications- Nissen or Nissen-Rosseti modification (with the division of short gastric vessels). We analyzed the impact of the technical details incorporated in these procedures, such as the type of hiatal closure, division of short gastric vessels, length of fundoplication on the incidence of postoperative dysphagia with regard to the solid food. Patients with intact barium swallowing act were selected for endoscopy treatment after a minimally six weeks conservative therapy. When the enter to the stomach was narrow the endoscopist performed a dilatation. Results: Three patients underwent the endoscopic dilatation, and we observed one new reflux symptoms after our laparoscopic procedures.We did not detect any complication, such as disruption of the fundoplication resulted from endoscopic dilatation. Dysphagia was resolved after dilatation in all cases. Conclusion: There is no reliable preoperative test to predict dysphagia. Technical modifications, such as the division of short gastric vessels and the method of hiatal closure have not influenced the incidence of the postoperative dysphagia. The reason for the postoperative dysphagia is the technical performans of fundoplication and the approach applied by the surgeon rather then the type of surgical procedure. The endoscopic dilatation is safe and often effective in patients with postfundoplication dysphagia. Dysphagia;Nissen Fundoplication;Nissien-Rosseti Fundoplication;Endoscopic Dilatation

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