Document Detail


Endolaparoscopic approach in the management of gastroesophageal reflux disease: an experimental study in pigs.
MedLine Citation:
PMID:  17907978     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Chronic reflux of gastric content to the esophagus causes retrosternal burning, pain, and regurgitation, and results in histopathologic changes that may culminate in adenocarcinoma. Insufficiency of the lower esophageal sphincter and hiatal hernia are the two principal causative factors. In this paper, we present the early results of a new antireflux operation in pigs. MATERIALS AND METHODS: The status of physiologic reflux was determined in 5 pigs (approximately 40-45 kg) with 24-hour pH monitorization. Under endoscopic guidance, a trocar was inserted into the stomach (similar to the percutaneous endoscopic gastrostomy technique). The endoscope was put into the retroflexed position; a mucomuscular pursestring suture was placed around the endoscope at the cardia and tied. Ten days later, pH monitorization was repeated to evaluate the effectiveness of the method. Late postoperative results have been reevaluated by 24-hour pH monitorization in the sixth month. RESULTS: The procedure achieved statistically significant improvements in total reflux time, number of reflux periods, number of long reflux periods, the longest reflux period, and the DeMeester score. The preoperative and postoperative DeMeester scores of the individual animals were 179.24-0.94, 11.48-0.98, 68.4-3.74, 132.2-46.49, and 38.72-5.86, respectively. Even though there appeared to be a slight increase in the pH monitorization levels after 6 months, these results did not reach significant degrees, and compared to the physiological reflux, the results were remarkable. CONCLUSIONS: The results obtained showed considerable decreases in physiologic reflux in all animals. We believe that this endoluminal, laparoendoscopic operation can be used in the treatment of gastroesophageal reflux disease as a minimally invasive method.
Authors:
Yavuz Selim Sari; Oguz Koc; Vahit Tunali; Esin Erkan; Gungor Uzum; Cem Sayilgan; Guniz Koksal; Serdal Ugurlu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of laparoendoscopic & advanced surgical techniques. Part A     Volume:  17     ISSN:  1092-6429     ISO Abbreviation:  J Laparoendosc Adv Surg Tech A     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-02     Completed Date:  2008-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706293     Medline TA:  J Laparoendosc Adv Surg Tech A     Country:  United States    
Other Details:
Languages:  eng     Pagination:  639-44     Citation Subset:  IM    
Affiliation:
Department of General Surgery, SB Istanbul Egitim ve Arastirma Hastanesi, Istanbul, Turkey. yssari@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Animals
Disease Models, Animal
Esophagoscopy
Female
Gastroesophageal Reflux / surgery*
Gastroscopy
Hydrogen-Ion Concentration
Laparoscopy / methods*
Monitoring, Physiologic
Statistics, Nonparametric
Swine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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