Complete Fundoplications: Indications and Technique

Engström, Christer; Lundell, Lars

doi:10.1007/978-1-4939-1749-5_9

Cited by 1 publication

(1 citation statement)

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“…To highlight the crucial necessity, we summarize with quotations from leading physicians treating esophageal diseases: 1) 'Manometry is critical in order to rule out achalasia or other motility disturbances which may predispose to dysphagia after surgery' [29]. 2) 'The complete absence of motility on the other hand is widely considered a red flag and often an indication for a partial wrap' [30].…”

Section: Resultsmentioning

confidence: 99%

Before and after Esophageal Surgery: Which Information Is Needed from the Functional Laboratory

Gockel

Rabe

Niebisch³

2018

Visc Med

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Background: Indications for benign esophageal surgery and postoperative follow-up need to be highly elaborated with differentiated and structured algorithms, based on objective functional workup in the esophageal laboratory. Functional outcome is of utmost interest and has to be driven by the need for comprehensive but purposeful diagnostic methods. Methods: Preoperative diagnostic workup procedures by the functional laboratory include 24-h pH-monitoring, impedance testing, and high-resolution manometry (HRM) - in addition to upper gastrointestinal endoscopy and barium swallow/timed barium esophagogram. Results: The most frequent indications for benign esophageal surgery are gastroesophageal reflux disease and achalasia; quite rare indications are esophageal diverticula and benign tumors. Esophageal motility testing in addition to 24-h pH-monitoring is crucial before antireflux surgery (ARS) in order to rule out ineffective esophageal motility and to tailor the wrap. With respect to achalasia surgery, the exact type of achalasia (I-III) has to be labeled according to the Chicago classification, and other motility disorders have to be excluded. The postoperative functional evaluation in the early phase (6 months) after either ARS or Heller's myotomy serves as the new baseline motility testing in case of later occurring disturbances in the follow-up. Conclusion: A complete and proper preoperative esophageal function assessment is crucial in order to rule out a primary motility disorder and to avoid postoperative functional complications.

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Section: Resultsmentioning

confidence: 99%