Effect of Vagus Nerve Injury on the Outcome of Antireflux Surgery: An Extensive Literature Review

Rijn, Selwyn van; Roebroek, Yvonne G. M.; Conchillo, José M.; Bouvy, Nicole D.; Masclee, A.A.M.

doi:10.1159/000444147

Cited by 155 publications

(5 citation statements)

References 56 publications

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“…Dicha plicatura, sin embargo, tiene más posibilidades de perder efectividad a largo plazo, como ocurre con los procedimientos endoscópicos, que la resección del estómago excedente tras GV. La conversión a una anatomía normal tras un BPGYR puede afectar al vaciamiento gástrico y ocasionar reflujo gastroesofágico, diarreas, náuseas o vómitos por la disminución de la motilidad gástrica asociada a la cirugía previa o a lesión del nervio vago [12], pero en general no se producen grandes alteraciones o complicaciones, salvo la reganancia de peso. Por tanto, la conversión a una GV puede evitar la reganancia de peso [11].…”

Section: Discussionunclassified

Detalles técnicos de la reconversión de bypass gástrico a gastrectomía vertical laparoscópica por hipoglucemia reactiva grave refractaria.

Martínez Caballero

2022

BMI Journal

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El bypass gástrico en Y de Roux (BPGYR) puede asociarse a distintas complicaciones, y algunas de ellas pueden requerir una reintervención quirúrgica como la hipoglucemia reactiva o postprandial (HP). Aunque la HP suele ser leve y asintomática, en ocasiones, puede ser refractaria al tratamiento médico. Para estas complicaciones, una alternativa eficaz es la conversión de una técnica derivativa a una restrictiva que permita el paso del alimento por el duodeno. Presentamos el caso de una paciente de 44 años intervenida en 2010 por obesidad tipo III (IMC 42.9 kg/m2) mediante BPGYR con adecuada pérdida ponderal (IMC 30.25 kg/m2) que presentaba numerosas hipoglucemias reactivas graves y refractarias a tratamiento médico, por lo que fue tratada a una conversión quirúrgica con gastrectomía vertical laparoscópica (GV). Tras un seguimiento de 12 meses se han reducido la intensidad y la frecuencia de los episodios de HP.Technical details of the conversion of gastric bypass to laparoscopic vertical gastrectomy due to severe refractory reactive hypoglycemia.

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Section: Discussionunclassified

Detalles técnicos de la reconversión de bypass gástrico a gastrectomía vertical laparoscópica por hipoglucemia reactiva grave refractaria.

Martínez Caballero

2022

BMI Journal

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“…Five hundred fifty-nine patients with an intact vagus nerve were compared to 331 patients with vagal nerve injury or dissection. Diarrhea, dumping syndrome, delayed gastric emptying, and gas bloating were less common in patients with intact vagal nerves than in patients with dissected or injured vagal nerves [ 23 ].…”

Section: Preservation Of the Vagus Nervesmentioning

confidence: 99%

Evidence mapping on how to perform an optimal surgical repair of large hiatal hernias

Nickel,

Müller,

Cizmic

et al. 2023

Langenbecks Arch Surg

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Background Symptomatic and large hiatal hernia (HH) is a common disorder requiring surgical management. However, there is a lack of systematic, evidence-based recommendations summarizing recent reviews on surgical treatment of symptomatic HH. Therefore, this systematic review aimed to create evidence mapping on the key technical issues of HH repair based on the highest available evidence. Methods A systematic review identified studies on eight key issues of large symptomatic HH repair. The literature was screened for the highest level of evidence (LE from level 1 to 5) according to the Oxford Center for evidence-based medicine’s scale. For each topic, only studies of the highest available level of evidence were considered. Results Out of the 28.783 studies matching the keyword algorithm, 47 were considered. The following recommendations could be deduced: minimally invasive surgery is the recommended approach (LE 1a); a complete hernia sac dissection should be considered (LE 3b); extensive division of short gastric vessels cannot be recommended; however, limited dissection of the most upper vessels may be helpful for a floppy fundoplication (LE 1a); vagus nerve should be preserved (LE 3b); a dorso-ventral cruroplasty is recommended (LE 1b); routine fundoplication should be considered to prevent postoperative gastroesophageal reflux (LE 2b); posterior partial fundoplication should be favored over other forms of fundoplication (LE 1a); mesh augmentation is indicated in large HH with paraesophageal involvement (LE 1a). Conclusion The current evidence mapping is a reasonable instrument based on the best evidence available to guide surgeons in determining optimal symptomatic and large HH repair.

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“…La injuria no intencionada del nervio vago ocurre en un 10 a 42% de las funduplicaturas. 151 Un estudio que comparó la distensibilidad pilórica con sonda de imagen luminal funcional (FLIP, por su sigla en inglés), luego de diferentes cirugías, demostró que la mayor reducción de la distensibilidad pilórica ocurrió de forma posterior a la cirugía antirreflujo y a la esofaguectomía. 152 Sin embargo, se ha reportado que los síntomas de estasis gástrica persisten solo en una minoría de los pacientes al año de una funduplicatura de Nissen.…”

Section: Gastroparesia Posquirúrgicaunclassified

Dispepsia funcional y gastroparesia: ¿dos entidades superpuestas? De la fisiopatología a la terapéutica

Manresa¹,

Carboné²,

Díez³

2021

Acta gastroenterol. latinoam.

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Functional dyspepsia and gastroparesis represent the most common sensory-motor disorders of the upper gastrointestinal tract. Scientific advances in the last decade have shown that there is significant overlap between them. This review aims to address current knowledge about their pathophysiology, diagnosis and treatment. Functional dyspepsia is a medical condition that is characterized by one or more of the following symptoms: early satiety, postprandial fullness, and epigastric pain or burning. The pathophysiological mechanisms involved are: the gastroduodenal motility and sensory abnormalities, the immune dysfunction, the duodenal inflammation, the gastrointestinal infections, the alterations in the gastrointestinal microbiota and the dysfunction of the gut-brain axis. The Rome IV criteria make possible to establish a presumptive diagnosis of functional dyspepsia in most patients, although it continues to be a diagnosis of exclusion that requires the performance of an upper digestive video endoscopy to confirm it. The recommended therapeutic options are: the eradication of Helicobacter pylori, the proton pump inhibitors, the tricyclic antidepressants and prokinetics. Gastroparesis is a chronic disorder characterized by delayed gastric emptying in the absence of a mechanical obstruction. The pathophysiology is caused by neuromuscular abnormalities of gastric motor function. Gastric emptying scan is the current gold standard for diagnosis. The mainstays of treatment are restoration of hydration and nutrition, and pharmacological treatment with prokinetics and antiemetics.

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Effect of Vagus Nerve Injury on the Outcome of Antireflux Surgery: An Extensive Literature Review

Cited by 155 publications

References 56 publications

Detalles técnicos de la reconversión de bypass gástrico a gastrectomía vertical laparoscópica por hipoglucemia reactiva grave refractaria.

Detalles técnicos de la reconversión de bypass gástrico a gastrectomía vertical laparoscópica por hipoglucemia reactiva grave refractaria.

Evidence mapping on how to perform an optimal surgical repair of large hiatal hernias

Dispepsia funcional y gastroparesia: ¿dos entidades superpuestas? De la fisiopatología a la terapéutica

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