Pyloroplasty Offers Relief of Postfundoplication Gastroparesis in Patients Who Improved After Botulinum Toxin Injection
| العنوان: | Pyloroplasty Offers Relief of Postfundoplication Gastroparesis in Patients Who Improved After Botulinum Toxin Injection |
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| المؤلفون: | John C. Fang, Abbie V. Brickley, Robert E. Glasgow, Eric Volckmann, Daniel Gilsdorf, Linda J. Taylor |
| المصدر: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 27:1180-1184 |
| بيانات النشر: | Mary Ann Liebert Inc, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Adult, Male, medicine.medical_specialty, Gastroparesis, Botulinum toxin injection, Injections, Intralesional, Pyloroplasty, 03 medical and health sciences, 0302 clinical medicine, Chart review, medicine, Humans, In patient, Botulinum Toxins, Type A, Onabotulinumtoxin a, Digestive System Surgical Procedures, Pylorus, Aged, Retrospective Studies, Gastric emptying, Anti-Dyskinesia Agents, business.industry, Middle Aged, Plastic Surgery Procedures, medicine.disease, Conversion to Open Surgery, Surgery, Treatment Outcome, Gastric Emptying, 030220 oncology & carcinogenesis, Anesthesia, Operative time, Female, 030211 gastroenterology & hepatology, business |
| الوصف: | Endoscopic intrapyloric Botox (onabotulinumtoxin A; Allergan Pharmaceuticals) injections can improve postfundoplication gastroparesis, but responses are not durable. Surgical pyloroplasty may relieve gastroparetic symptoms, but patient selection criteria are poorly defined. We hypothesize that pyloroplasty provides durable improvement in patients whose symptoms improved after Botox injection.A retrospective chart review was performed of patients with postfundoplication gastroparesis who improved after Botox injection and then underwent pyloroplasty. Gastric emptying studies (GES), Gastroparesis Cardinal Symptom Index (GCSI) score, symptoms, and outcomes were reviewed.Ten patients received Heineke-Mikulicz pyloroplasty after reporting improvement with Botox injection. The mean operative time was 114 minutes (range 55-234 minutes). Three of 10 patients required conversion to open surgery, and the median length of stay was 3 days. Gastroparesis symptom improvement occurred in 9 of 10 patients. Postoperative GES normalized in 5/5 patients (median 205 decreased to 70 min, P .05). Median preoperative GCSI was 3.67, improved to 2.22 at 1 month postsurgery (P = .010) and to 2.11 on most recent follow-up (P = .015). Median duration of follow-up was 34 months (range 1-101 months).Heineke-Mikulicz pyloroplasty can improve symptoms and gastric emptying times in patients with postfundoplication gastroparesis. Improvement with intrapyloric Botox injection may select candidates for pyloroplasty. |
| تدمد: | 1557-9034 1092-6429 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e570b8f22aa52a3c8ef8047ebac19501 https://doi.org/10.1089/lap.2017.0099 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....e570b8f22aa52a3c8ef8047ebac19501 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15579034 10926429 |
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