New approaches to the management of gastroesophageal reflux:
Gespeichert in:
Format: | Buch |
---|---|
Sprache: | English |
Veröffentlicht: |
Hagerstown
Lippincott-Raven
1996
|
Schriftenreihe: | Problems in general surgery
13,2 |
Schlagworte: | |
Online-Zugang: | Inhaltsverzeichnis |
Beschreibung: | XV, 114 S. Ill., graph. Darst. |
Internformat
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Datensatz im Suchindex
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adam_text | CONTENTS
Preface xiii
Gastroesophageal Reflux Disease: Basic Considerations 1
Marco G. Patti and Vittorio Bresadola
The pathophysiology of gastroesophageal reflux disease is multifactorial. Suc¬
cessful antireflux surgery requires (a) complete preoperative evaluation by UGI
series, endoscopy, esophageal manometry, and ambulatory pH monitoring; and
(b) tailoring the operation to the results of these tests.
Pathology of Gastroesophageal Reflux Disease 9
David C. Gotley and London Lucien P. J. Ooi
The histologic response of the esophagus to gastroesophageal reflux varies
from mild inflammatory cell infiltration, through ulceration, fibrous stricture
formation to Barrett s esophagus, or columnar lined esophagus. Intestinal, vil
liform architecture in Barrett s esophagus has malignant potential, and recog¬
nition of dysplastic change, particularly when severe (or high grade), provides
a reliable marker for impending malignant change. A better understanding of
the cellular and molecular biological changes in Barrett s esophagus may pro¬
vide new insights into the pathophysiology and more reliable indicators of pa¬
tients at risk from this increasingly common disease.
Medical Management of Gastroesophageal Reflux 19
J. Patrick Waring
The medical management of gastroesophageal reflux consists of lifestyle mod¬
ifications, H2 receptor blockers, prokinetic agents, and proton pump inhibitors.
Proper use of these tools will result in long term success in 85 90% of patients.
Gastroesophageal Reflux Disease: Indications for Surgery,
Preoperative Evaluation, and Choice of Operation 29
Elizabeth A. Rafferty and David W. Rattner
Numerous tests are available to clinicians to select those patients who will ben¬
efit from antireflux surgery. A rational plan of preoperative patient evaluation
should also suggest the appropriate operative procedure for the clinical situa¬
tion.
Technique of Laparoscopic Nissen Fundoplication 39
William S. Laycock and John G. Hunter
Laparoscopic surgery has generated an increased awareness for surgery as a
treatment of gastroesophageal reflux disease. With proper patient selection and
attention to surgical technique, a surgeon should be able to consistently pro¬
duce good outcomes with laparoscopic antireflux surgery.
vi CONTENTS
Challenges in Laparoscopic Fundoplication and Controversies in
Operative Technique 51
Jeffrey H. Peters
The goal of surgical treatment for gastroesophageal reflux disease is to relieve the
symptoms of reflux by restoring competence of the cardia. The challenge is to ac¬
complish this over the patient s lifetime, with minimal morbidity and without in¬
ducing dysphagia. Patient features, including esophageal body failure, shortening
of the esophagus, and obesity, along with the technical difficulties often associat¬
ed with laparoscopic fundoplication, challenge the surgeon in achieving the goal
of long term success.
Results and Complications of Laparoscopic Nissen Fundoplication 67
Galen Perdikis, Ronald A. Hinder, Charles J. Filipi, Richard J. Lund,
and Natsuya Katada
The laparoscopic approach for the surgical management of gastroesophageal re¬
flux disease has shown itself to be at least as effective as the open procedure with
all of the advantages of minimally invasive surgery.
Laparoscopic Partial Fundoplications 75
Lee L. Swanstrom
Laparoscopic partial fundoplications are an important technique for treatment of
reflux disease in patients who have esophageal motility disorders. Their low inci¬
dence of postoperative side effects makes them appealing alternatives to the tra¬
ditional Nissen repair. Widespread application of partial fundoplications for un¬
complicated reflux disease awaits validation of long term outcome studies.
A Comparison of Outcomes with Open and Laparoscopic Fundoplication 85
Nathaniel! Soper
Long term outcome following open fundoplication for GERD is good in 85%
of patients. Laparoscopic fundoplication results in excellent short term outcome;
prolonged follow up and randomized trials will be needed to confirm the pur¬
ported benefits of the laparoscopic approaches.
Failure of Fundoplication and the Results of Remedial Operation 89
Hubert! Stein andJ. Riidiger Siewert
Persistent, recurrent, or new symptoms occur in 5 20% of patients who had an an
tireflux procedure for gastroesophageal reflux disease. Technical errors and wrong
patient selection are the most common causes of failure of antireflux surgery. Re¬
current reflux is usually due to a breakdown of the repair. In contrast, postopera¬
tive dysphagia may be due to a myriad of causes, which include a slipped wrap, a
wrap that has been placed around the stomach, a too tight or too long wrap, the
development of a stricture, the presence of a primary esophageal motor disorder,
or a complication of these factors. The successful management of these patients
requires an individual therapeutic approach based on the presenting symptom con¬
stellation, the results of function tests, and the intraoperative findings.
CONTENTS vii
Thoracoscopy and Gastroesophageal Reflux Disease 97
J. K. Champion and J. Barry McKernan
The technique of thoracoscopic Belsey fundoplication is described with proposed
indications.
Esophagectomy for Complications of Gastroesophageal Reflux Disease 105
Namen Salamao, Louis Gaboury, and Andre Duranceau
Irreversible esophageal wall damage may indicate esophagectomy and esophageal
reconstruction. The main indications for an esophagectomy in our series were pri¬
mary and secondary reflux disease, reflux complications following treatment of
idiopathic motor disorders, and esophageal perforation during management of re¬
flux related complications.
Index 113
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physical | XV, 114 S. Ill., graph. Darst. |
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series | Problems in general surgery |
series2 | Problems in general surgery |
spelling | New approaches to the management of gastroesophageal reflux guest ed.: John G. Hunter ... Hagerstown Lippincott-Raven 1996 XV, 114 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Problems in general surgery 13,2 Chirurgie (DE-588)4009987-8 gnd rswk-swf Gastroösophagealer Reflux (DE-588)4197362-8 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Gastroösophagealer Reflux (DE-588)4197362-8 s Chirurgie (DE-588)4009987-8 s DE-604 Hunter, John G. Sonstige oth Problems in general surgery 13,2 (DE-604)BV000010147 13,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007332724&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
spellingShingle | New approaches to the management of gastroesophageal reflux Problems in general surgery Chirurgie (DE-588)4009987-8 gnd Gastroösophagealer Reflux (DE-588)4197362-8 gnd |
subject_GND | (DE-588)4009987-8 (DE-588)4197362-8 (DE-588)4143413-4 |
title | New approaches to the management of gastroesophageal reflux |
title_auth | New approaches to the management of gastroesophageal reflux |
title_exact_search | New approaches to the management of gastroesophageal reflux |
title_full | New approaches to the management of gastroesophageal reflux guest ed.: John G. Hunter ... |
title_fullStr | New approaches to the management of gastroesophageal reflux guest ed.: John G. Hunter ... |
title_full_unstemmed | New approaches to the management of gastroesophageal reflux guest ed.: John G. Hunter ... |
title_short | New approaches to the management of gastroesophageal reflux |
title_sort | new approaches to the management of gastroesophageal reflux |
topic | Chirurgie (DE-588)4009987-8 gnd Gastroösophagealer Reflux (DE-588)4197362-8 gnd |
topic_facet | Chirurgie Gastroösophagealer Reflux Aufsatzsammlung |
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