Laparoscopic antireflux surgery for the treatment of esophageal strictures refractory to medical therapy View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1999-03-01

AUTHORS

Kenneth R DeVault, Matthias H Seelig, Neil R Floch, Paul J Klingler, Robert A Cina, Ronald A Hinder, Susan A Branton

ABSTRACT

OBJECTIVE: The response of esophageal strictures to laparoscopic antireflux surgery remains controversial. The aim of this study was to examine the outcome of patients with medically refractory esophageal strictures caused by severe gastroesophageal reflux disease and treated surgically. METHODS: A prospective follow-up analysis was completed using data obtained from detailed specific questioning by an independent observer. Responses were rated for symptoms, dysphagia (range 1-19), satisfaction with treatment, well-being (1 = best, 10 = worst), and need for further therapy. RESULTS: Of 102 patients, 74 (72.5%) responded to follow-up. There were 31 women, mean age 59.6 yr, and 43 men, mean age 55.2 yr. Mean follow-up was 25 months (range 4-68 months). A total of 252 dilations before surgery decreased to 29 after surgery (p < 0.0001) in the mean observation period of 26 months before and 25 months after surgery (mean/patient 5.3 and 1.8, respectively, p < 0.001). The mean dysphagia score was 6.8 +/- 3.6 preoperatively and 3.7 +/- 1.4 postoperatively (p < 0.0001). Nine (12%) patients required continuous postoperative H2-blockers or proton pump inhibitors. Seven of these had gastritis or peptic ulcer disease. Before antireflux surgery, 10 (13.5%) had frequent pneumonia. No pneumonia was observed after surgery. Sixty-eight (91.9%) patients were satisfied with their decision to have surgery. Among these, the well-being score was 1.8 +/- 0.4 postoperatively vs 5.5 +/- 1.2 (p < 0.001) preoperatively. CONCLUSIONS: Laparoscopic surgery in patients with medically refractory esophageal strictures results in a good clinical outcome with minimal complications. Patients are very satisfied with relief of dysphagia, and there is a diminished need for further dilation, with good quality of life. More... »

PAGES

632

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1111/j.1572-0241.1999.00926.x

DOI

http://dx.doi.org/10.1111/j.1572-0241.1999.00926.x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1037262265

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/10086643


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