دورية أكاديمية
The laparoscopic Nissen-Hill hybrid: pilot study of a combined antireflux procedure.
| العنوان: | The laparoscopic Nissen-Hill hybrid: pilot study of a combined antireflux procedure. |
|---|---|
| المؤلفون: | Qureshi AP; University of Toronto, Toronto, ON, Canada., Aye RW, Buduhan G, Knight A, Orlina J, Farivar AS, Wagner OJ, McHugh S, Louie BE |
| المصدر: | Surgical endoscopy [Surg Endosc] 2013 Jun; Vol. 27 (6), pp. 1945-52. Date of Electronic Publication: 2013 Jan 10. |
| نوع المنشور: | Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Germany NLM ID: 8806653 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2218 (Electronic) Linking ISSN: 09302794 NLM ISO Abbreviation: Surg Endosc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 1992- : New York : Springer Original Publication: [Berlin] : Springer International, c1987- |
| مواضيع طبية MeSH: | Barrett Esophagus/*surgery , Fundoplication/*methods , Gastroesophageal Reflux/*surgery , Hernia, Hiatal/*surgery , Laparoscopy/*methods, Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Pilot Projects ; Postoperative Care ; Quality of Life ; Suture Techniques ; Treatment Outcome |
| مستخلص: | Background: Laparoscopic antireflux surgery is highly effective in patients with uncomplicated gastroesophageal reflux disease (GERD). However, long-term failure rates in paraesophageal hernia (PEH) and Barrett's metaplasia (BE) are higher and warrant a more durable repair. Outcomes for the laparoscopic Nissen fundoplication (LNF) and Hill repair (LHR) are equivalent, but their anatomic components are different and may complement each other (Aye R Ann Thorac Surg, 2012). We designed and tested the feasibility and safety of an operation that combines the essential components of each repair. Methods: A prospective, phase II pilot study was performed on patients with symptomatic giant PEH hernias and/or GERD with nondysplastic Barrett's metaplasia. Pre- and postoperative esophagogastroduodenoscopy (EGD), upper gastrointestinal study (UGI), 48-hour pH testing, manometry, and three quality-of-life metrics were obtained. Results: Twenty-four patients were enrolled in the study. Three patients did not complete the planned procedure, leaving 21 patients, including 12 with PEH, 7 with BE, and 2 with both. There were no 30-day or in-hospital mortalities. At a median follow-up of 13 (range 6.4-30.2) months, there were no reoperations or clinical recurrences. Two patients required postoperative dilation for dysphagia, with complete resolution. Mean DeMeester scores improved from 54.3 to 7.5 (p < 0.0036). Mean lower esophageal sphincter pressures (LESP) increased from 8.9 to 21.3 mmHg (p < 0.013). Mean short-term and long-term QOLRAD scores improved from 4.09 at baseline to 6.04 and 6.48 (p < 0.0001). Mean short-term and long-term GERD-HQRL scores improved from 22.9 to 7.5 and 6.9 (p < 0.03). Mean long-term Dysphagia Severity Score Index improved from 33.3 to 40.6 (p < 0.064). Conclusions: The combination of a Nissen plus Hill hybrid reconstruction of the gastroesophageal junction (GEJ) is technically feasible, safe, and not associated with increased side effects. Short-term clinical results in PEH and BE suggest that this may be an effective repair, supporting the value of further study. |
| References: | Ann Surg. 2006 Jul;244(1):42-51. (PMID: 16794388) Ann Surg. 1999 Oct;230(4):595-604; discussion 604-6. (PMID: 10522729) Surg Endosc. 2005 Nov;19(11):1439-46. (PMID: 16206005) Surg Innov. 2006 Dec;13(4):238-49. (PMID: 17227922) Eur J Surg Suppl. 1998;(583):41-9. (PMID: 10027672) Surg Endosc. 2000 Mar;14(3):282-8. (PMID: 10741450) World J Surg. 2008 Jun;32(6):995-8. (PMID: 18224465) Ann Surg. 1999 May;229(5):669-76; discussion 676-7. (PMID: 10235525) Am J Surg. 1994 May;167(5):542-6. (PMID: 8185045) J Gastrointest Surg. 2007 Sep;11(9):1138-45. (PMID: 17619938) J Gastrointest Surg. 2002 Mar-Apr;6(2):181-8; discussion 188. (PMID: 11992803) J Gastrointest Surg. 2012 Mar;16(3):453-9. (PMID: 22215243) Dis Esophagus. 2007;20(2):130-4. (PMID: 17439596) J Gastrointest Surg. 2011 Mar;15(3):389-96. (PMID: 21246416) J Clin Gastroenterol. 1992 Mar;14(2):99-100. (PMID: 1556441) J Gastrointest Surg. 2006 Nov;10(9):1312-6; discussion 1316-7. (PMID: 17114017) Best Pract Res Clin Gastroenterol. 2004 Oct;18(5):935-45. (PMID: 15494287) Gut. 2008 Sep;57(9):1207-13. (PMID: 18469091) J Thorac Cardiovasc Surg. 2010 Feb;139(2):395-404, 404.e1. (PMID: 20004917) Surgery. 1998 Jun;123(6):645-57. (PMID: 9626315) Ann Surg. 2006 Oct;244(4):481-90. (PMID: 16998356) Ann Surg. 2011 Feb;253(2):291-6. (PMID: 21217518) Arch Surg. 1999 Aug;134(8):809-15; discussion 815-7. (PMID: 10443802) Am Surg. 2003 Oct;69(10):833-8. (PMID: 14570358) |
| تواريخ الأحداث: | Date Created: 20130112 Date Completed: 20140116 Latest Revision: 20211021 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1007/s00464-012-2692-7 |
| PMID: | 23306589 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1432-2218 |
|---|---|
| DOI: | 10.1007/s00464-012-2692-7 |