Long term results of the thoracoscopic Collis-Laparoscopic Nissen for the treatment of severe GERD with acquired short esophagus.
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, O; Aramini, B; Lugaresi, Ml; Ruffato, A; Mattioli, S.. - In: DISEASES OF THE ESOPHAGUS. - ISSN 1120-8694. - (2012). (Intervento presentato al convegno 20th European Conference on General Thoracic Surgery. tenutosi a Essen, Germany. nel 10-13 June 2012.).
Long term results of the thoracoscopic Collis-Laparoscopic Nissen for the treatment of severe GERD with acquired short esophagus.
Aramini B;
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.
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