Tratamento cirurgico videolaparoscopio da doença de refluxo gastroesofagiano : tecnica de Nissen modificada - resultados clinicos e funcionais

AUTOR(ES)
DATA DE PUBLICAÇÃO

1998

RESUMO

A group of 59 patients with gastroesophageal reflux disease were submitted to surgical treatment by videolaparosocopic Nissen modified technique. The time of clinical history was 77,42 months and they have been all submitted to many clinical treatment. Most of patients were female: 54,2% and the age was between 15 and 82 years old with average of 52,57 years of age. The preoperative diagnosis was confirmed by clinical evaluation, barium meal, upper gastrointestinal endoscopy in all patients. The preoperative esophageal manometry was performed in 35 patients and scintiscanning in 15 patients. The diagnosis of esophagitis without complications was identified in 27 ofthe patients (45,8%) and esophagitis with complications in 32 of them (54,2%). The Barrett epithelium was found in 21 patients (35,6%). The laparoscopic technque was performed in all patients without need of conversion to open surgery. Mean surgery time was 123,89 minutes. Colecistectomy was performed in the same surgery in 9 patients (15,5%). One patient had duodeanl ulcer with stenosis and Zenker s diverticulum; he was treated in the same surgery. There were not major intraoperative complications; one patient died in the first day after operation because he had partial wrap necrosis. The discharge from hospital occurred in 48 hours. The early symptons until the 30th day posoperative occurred in 48% of the patients with espontaneous resolution in the majority. The follow-up was 20,8 months. About 10% of the patients had symptons of reêlfg!tation, heartbum and dysfagia. One patient was reoperated because persistent reflux and esophagitis with stenosis. Gas bloat syndrome was observed in 5,3% ofthe patients. The posoperative evaluation was performed in 39 patients with barium meal, 53 had upper gastrointestinal endoscopy, 34 patients had esophageal manometry and 40 had scintiscanninK The paraesophageal hemia was diagnosticated in 5% of them. Statistics shows a significant increase "of good rtesults when compared with preoperative parameters. Overall efficiency ofthe surgical treatment was 93,1% according with Visick classification

ASSUNTO(S)

esofago - cirurgia refluxo gastroesofagico laparoscopia

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