Gastric emptying and antireflux surgery

Estevão‐Costa, José; Fragoso, Ana Catarina; Prata, Maria José; Campos, Miguel; Trindade, Eunice; Dias, Jorge Amil; Brazão, A. Maria

doi:10.1007/s00383-010-2702-6

Cited by 19 publications

(5 citation statements)

References 30 publications

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“…In linear regression analysis, GE was, however, not a significant predictor. LARS did significantly improve GE in patients with preoperative delayed or severely delayed GE, which has also been demonstrated in adults [ 47 , 48 ] and children [ 49 ] that have undergone LARS.…”

Section: Discussionsupporting

confidence: 60%

Effects and efficacy of laparoscopic fundoplication in children with GERD: a prospective, multicenter study

et al. 2016

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IntroductionLaparoscopic antireflux surgery (LARS) in children primarily aims to decrease reflux events and reduce reflux symptoms in children with therapy-resistant gastroesophageal reflux disease (GERD). The aim was to objectively assess the effect and efficacy of LARS in pediatric GERD patients and to identify parameters associated with failure of LARS.MethodsTwenty-five children with GERD [12 males, median age 6 (2–18) years] were included prospectively. Reflux-specific questionnaires, stationary manometry, 24-h multichannel intraluminal impedance pH monitoring (MII-pH monitoring) and a 13C-labeled Na-octanoate breath test were used for clinical assessment before and 3 months after LARS.ResultsAfter LARS, three of 25 patients had persisting/recurrent reflux symptoms (one also had persistent pathological acid exposure on MII-pH monitoring). New-onset dysphagia was present in three patients after LARS. Total acid exposure time (AET) (8.5–0.8 %; p < 0.0001) and total number of reflux episodes (p < 0.001) significantly decreased and lower esophageal sphincter (LES) resting pressure significantly increased (10–24 mmHg, p < 0.0001) after LARS. LES relaxation, peristaltic contractions and gastric emptying time did not change. The total number of reflux episodes on MII-pH monitoring before LARS was a significant predictor for the effect of the procedure on reflux reduction (p < 0.0001).ConclusionsIn children with therapy-resistant GERD, LARS significantly reduces reflux symptoms, total acid exposure time (AET) and number of acidic as well as weakly acidic reflux episodes. LES resting pressure increases after LARS, but esophageal function and gastric emptying are not affected. LARS showed better reflux reduction in children with a higher number of reflux episodes on preoperative MII-pH monitoring.

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Section: Discussionsupporting

confidence: 60%

Effects and efficacy of laparoscopic fundoplication in children with GERD: a prospective, multicenter study

et al. 2016

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“…Cranial displacement of the gastroesophageal junction owing to traction on the distal esophagus to achieve anastomosis, disproportion between the upper pouch and the fistula, and damage to esophageal innervation during dissection are some of the factors that may disturb the mechanisms that prevent GER [6]. In addition, the anomalous extrinsic and intrinsic innervation [7][8][9][10], the abnormal gastric motility with delayed gastric emptying associated with a slower myoelectric gastric activity undoubtedly plays a crucial role in the pathogenesis of GER in these patients [11][12][13][14][15][16]. Survivors of the repair of isolated duodenal atresia also suffer significant gastrointestinal morbidity such as megaduodenum (up to 95%), bile reflux gastritis (up to 45%), esophagitis and gastritis (up to 35%), GER (up to 17%), and delayed transit (up to 12%) [4,17,18].…”

Section: Discussionmentioning

confidence: 99%

Defective upper gastrointestinal function after repair of combined esophageal and duodenal atresia

Fragoso

Ortiz

Hernández

et al. 2015

Journal of Pediatric Surgery

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“…6,21,27,29 Apesar do papel fisiopatológico do esvaziamento gástrico lento na DRGE, 21,27,29 nenhum dos doentes foI submetido a piloroplastia/piloromiotomia, dado já ter sido demonstrado que o esvaziamento gástrico lento tende a normalizar após cirurgia antirrefluxo. 30,31…”

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Cirurgia Laparoscópica do Refluxo Gastroesofágico na Criança

et al. 2013

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Introduction: Gastroeshophageal reflux is a common but usually innocuous condition in children. However, in the presence of Gastroeshophageal reflux disease, the surgical treatment (open or laparoscopic) may be indicated. This study aimed to evaluate the feasibility, effectiveness and safety of laparoscopic antireflux surgery (Nissen fundoplication) with emphasis in infants.Material and Methods: Children with gastroeshophageal reflux proposed for laparoscopic antireflux surgery between January 2006 and December 2012 in a pediatric surgery department of a university hospital were studied. A descriptive and comparative analysis was conducted with regard to age (group I: <1 year, group II: 1-3 years, group III: > 3 years) and presence of comorbidities. Demographics, symptoms, comorbidities, operative indications, perioperative and postoperative outcome were assessed. The statistical significance level was set at 5%.Results: 55 children were proposed for surgery: 12 of group I, 15 group of II and 28 of group III. 50.9% had comorbidities (21 central nervous system disease and 7 esophageal atresia). In 52 (94.5%) cases, antireflux surgery was performed by laparoscopy. The procedure lasted 167 ± 42 minutes, with no significant differences according to age groups, although higher in those with central nervous system disease. With a follow-up of 35.5 ± 23.9 months, the following complications occurred: gas-bloat syndrome, dumping or dysphagia in 8 cases (15.7%) and paraesophageal hernia in 2 cases (3.9%), with no significant differences between groups; there was clinical recurrence with reoperation in 2 cases.Conclusion: Laparoscopic Nissen fundoplication is a feasible and effective procedure, with minimal morbidity, including in infancy.

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Gastric emptying and antireflux surgery

Cited by 19 publications

References 30 publications

Effects and efficacy of laparoscopic fundoplication in children with GERD: a prospective, multicenter study

Effects and efficacy of laparoscopic fundoplication in children with GERD: a prospective, multicenter study

Defective upper gastrointestinal function after repair of combined esophageal and duodenal atresia

Cirurgia Laparoscópica do Refluxo Gastroesofágico na Criança

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