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Laparoscopic Partial Sleeve Gastrectomy with Fundoplication for Gastroesophageal Reflux and Delayed Gastric Emptying
Background A difficult management problem for the upper gastrointestinal surgeon exists when a patient presents with symptomatic and refractory severe delayed gastric emptying. Surgical treatment is further complicated by coexisting gastro-oesophageal reflux. No universal surgical strategy exists fo...
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Published in: | World journal of surgery 2015-06, Vol.39 (6), p.1460-1464 |
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container_title | World journal of surgery |
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creator | Le Page, Philip A. Martin, David |
description | Background
A difficult management problem for the upper gastrointestinal surgeon exists when a patient presents with symptomatic and refractory severe delayed gastric emptying. Surgical treatment is further complicated by coexisting gastro-oesophageal reflux. No universal surgical strategy exists for this problem.
Methods
A novel surgical strategy combines partial sleeve gastrectomy (SG) and hiatus hernia (HH) repair with fundoplication. A review of treating four such patients is described with objective outcome data.
Results
Overall, solid gastric emptying improved in all, from median 350 (163–488) min pre-operatively to 108 (84–135) at 10 months (3–24) post-operatively, corresponding to 67 % improvement. Primary symptoms resolved in all; however, one patient had recurrent symptoms. GERD-HRQL also improved in all, from median 23 (3–25) to 4 (0–8) at 21 months (6–30, 83 % improvement). Gas bloat improved in three. All had post-operative gastroscopies showing intact repair and absent oesophagitis, with no patient requiring post-operative PPI. Patient weight reduced by median 11 % (7–20) post-operatively. There was no significant peri-operative morbidity.
Conclusions
With careful patient selection and work-up, SG and HH repair with fundoplication may improve quality of life by coupling adequate reflux control with improved gastric emptying. |
doi_str_mv | 10.1007/s00268-015-2981-0 |
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A difficult management problem for the upper gastrointestinal surgeon exists when a patient presents with symptomatic and refractory severe delayed gastric emptying. Surgical treatment is further complicated by coexisting gastro-oesophageal reflux. No universal surgical strategy exists for this problem.
Methods
A novel surgical strategy combines partial sleeve gastrectomy (SG) and hiatus hernia (HH) repair with fundoplication. A review of treating four such patients is described with objective outcome data.
Results
Overall, solid gastric emptying improved in all, from median 350 (163–488) min pre-operatively to 108 (84–135) at 10 months (3–24) post-operatively, corresponding to 67 % improvement. Primary symptoms resolved in all; however, one patient had recurrent symptoms. GERD-HRQL also improved in all, from median 23 (3–25) to 4 (0–8) at 21 months (6–30, 83 % improvement). Gas bloat improved in three. All had post-operative gastroscopies showing intact repair and absent oesophagitis, with no patient requiring post-operative PPI. Patient weight reduced by median 11 % (7–20) post-operatively. There was no significant peri-operative morbidity.
Conclusions
With careful patient selection and work-up, SG and HH repair with fundoplication may improve quality of life by coupling adequate reflux control with improved gastric emptying.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-015-2981-0</identifier><identifier>PMID: 25651959</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Surgery ; Aged ; Cardiac Surgery ; Delayed Gastric Emptying ; Esophagitis - etiology ; Female ; Fundoplication ; Gastrectomy - methods ; Gastroesophageal Reflux - complications ; Gastroesophageal Reflux - surgery ; Gastroparesis - complications ; Gastroparesis - surgery ; Gastroscopy ; General Surgery ; Hernia, Hiatal - surgery ; Herniorrhaphy ; Hiatus Hernia ; Hiatus Hernia Repair ; Humans ; Innovative Surgical Techniques Around the World ; Medicine ; Medicine & Public Health ; Middle Aged ; Quality of Life ; Short Gastric Vessel ; Sleeve Gastrectomy ; Surgery ; Thoracic Surgery ; Treatment Outcome ; Vascular Surgery</subject><ispartof>World journal of surgery, 2015-06, Vol.39 (6), p.1460-1464</ispartof><rights>Société Internationale de Chirurgie 2015</rights><rights>2015 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4221-ee5a018b1e97a416d445cc372ab71f91ba4d829e08df87628803461fbba82a523</citedby><cites>FETCH-LOGICAL-c4221-ee5a018b1e97a416d445cc372ab71f91ba4d829e08df87628803461fbba82a523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25651959$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Le Page, Philip A.</creatorcontrib><creatorcontrib>Martin, David</creatorcontrib><title>Laparoscopic Partial Sleeve Gastrectomy with Fundoplication for Gastroesophageal Reflux and Delayed Gastric Emptying</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
A difficult management problem for the upper gastrointestinal surgeon exists when a patient presents with symptomatic and refractory severe delayed gastric emptying. Surgical treatment is further complicated by coexisting gastro-oesophageal reflux. No universal surgical strategy exists for this problem.
Methods
A novel surgical strategy combines partial sleeve gastrectomy (SG) and hiatus hernia (HH) repair with fundoplication. A review of treating four such patients is described with objective outcome data.
Results
Overall, solid gastric emptying improved in all, from median 350 (163–488) min pre-operatively to 108 (84–135) at 10 months (3–24) post-operatively, corresponding to 67 % improvement. Primary symptoms resolved in all; however, one patient had recurrent symptoms. GERD-HRQL also improved in all, from median 23 (3–25) to 4 (0–8) at 21 months (6–30, 83 % improvement). Gas bloat improved in three. All had post-operative gastroscopies showing intact repair and absent oesophagitis, with no patient requiring post-operative PPI. Patient weight reduced by median 11 % (7–20) post-operatively. There was no significant peri-operative morbidity.
Conclusions
With careful patient selection and work-up, SG and HH repair with fundoplication may improve quality of life by coupling adequate reflux control with improved gastric emptying.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Cardiac Surgery</subject><subject>Delayed Gastric Emptying</subject><subject>Esophagitis - etiology</subject><subject>Female</subject><subject>Fundoplication</subject><subject>Gastrectomy - methods</subject><subject>Gastroesophageal Reflux - complications</subject><subject>Gastroesophageal Reflux - surgery</subject><subject>Gastroparesis - complications</subject><subject>Gastroparesis - surgery</subject><subject>Gastroscopy</subject><subject>General Surgery</subject><subject>Hernia, Hiatal - surgery</subject><subject>Herniorrhaphy</subject><subject>Hiatus Hernia</subject><subject>Hiatus Hernia Repair</subject><subject>Humans</subject><subject>Innovative Surgical Techniques Around the World</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Quality of Life</subject><subject>Short Gastric Vessel</subject><subject>Sleeve Gastrectomy</subject><subject>Surgery</subject><subject>Thoracic Surgery</subject><subject>Treatment Outcome</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNqFkcFu1TAQRS1ERV8LH8AGRWLDJnTGTmJ7CaWvUD0JREEsLSeZvKZK4tROKPn7ukpBqBJi5Vmcc3Xly9hLhLcIIE8CAC9UCpinXCtM4QnbYCZ4ygUXT9kGRJHFG8UhOwrhGgBlAcUzdsjzIked6w2bdna03oXKjW2VfLF-am2XXHZEPyk5t2HyVE2uX5LbdrpKtvNQu7FrKzu1bkga51fGUXDjld1TdL9S082_EjvUyQfq7EL1ysT4s36clnbYP2cHje0CvXh4j9n37dm304_p7vP5p9N3u7TKOMeUKLeAqkTS0mZY1FmWV5WQ3JYSG42lzWrFNYGqGyULrhSIrMCmLK3iNufimL1Zc0fvbmYKk-nbUFHX2YHcHAwWClALABHR14_Qazf7IbaLlNQRQ6kihStVxS8Lnhoz-ra3fjEI5n4Ss05i4iTmfhID0Xn1kDyXPdV_jN8bRECvwG3b0fL_RPPj4vL9FqSQGF2-uiFqw578X7X_2egOci6oBg</recordid><startdate>201506</startdate><enddate>201506</enddate><creator>Le Page, Philip A.</creator><creator>Martin, David</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201506</creationdate><title>Laparoscopic Partial Sleeve Gastrectomy with Fundoplication for Gastroesophageal Reflux and Delayed Gastric Emptying</title><author>Le Page, Philip A. ; Martin, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4221-ee5a018b1e97a416d445cc372ab71f91ba4d829e08df87628803461fbba82a523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Cardiac Surgery</topic><topic>Delayed Gastric Emptying</topic><topic>Esophagitis - etiology</topic><topic>Female</topic><topic>Fundoplication</topic><topic>Gastrectomy - methods</topic><topic>Gastroesophageal Reflux - complications</topic><topic>Gastroesophageal Reflux - surgery</topic><topic>Gastroparesis - complications</topic><topic>Gastroparesis - surgery</topic><topic>Gastroscopy</topic><topic>General Surgery</topic><topic>Hernia, Hiatal - surgery</topic><topic>Herniorrhaphy</topic><topic>Hiatus Hernia</topic><topic>Hiatus Hernia Repair</topic><topic>Humans</topic><topic>Innovative Surgical Techniques Around the World</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Quality of Life</topic><topic>Short Gastric Vessel</topic><topic>Sleeve Gastrectomy</topic><topic>Surgery</topic><topic>Thoracic Surgery</topic><topic>Treatment Outcome</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Le Page, Philip A.</creatorcontrib><creatorcontrib>Martin, David</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Le Page, Philip A.</au><au>Martin, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic Partial Sleeve Gastrectomy with Fundoplication for Gastroesophageal Reflux and Delayed Gastric Emptying</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2015-06</date><risdate>2015</risdate><volume>39</volume><issue>6</issue><spage>1460</spage><epage>1464</epage><pages>1460-1464</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
A difficult management problem for the upper gastrointestinal surgeon exists when a patient presents with symptomatic and refractory severe delayed gastric emptying. Surgical treatment is further complicated by coexisting gastro-oesophageal reflux. No universal surgical strategy exists for this problem.
Methods
A novel surgical strategy combines partial sleeve gastrectomy (SG) and hiatus hernia (HH) repair with fundoplication. A review of treating four such patients is described with objective outcome data.
Results
Overall, solid gastric emptying improved in all, from median 350 (163–488) min pre-operatively to 108 (84–135) at 10 months (3–24) post-operatively, corresponding to 67 % improvement. Primary symptoms resolved in all; however, one patient had recurrent symptoms. GERD-HRQL also improved in all, from median 23 (3–25) to 4 (0–8) at 21 months (6–30, 83 % improvement). Gas bloat improved in three. All had post-operative gastroscopies showing intact repair and absent oesophagitis, with no patient requiring post-operative PPI. Patient weight reduced by median 11 % (7–20) post-operatively. There was no significant peri-operative morbidity.
Conclusions
With careful patient selection and work-up, SG and HH repair with fundoplication may improve quality of life by coupling adequate reflux control with improved gastric emptying.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>25651959</pmid><doi>10.1007/s00268-015-2981-0</doi><tpages>5</tpages></addata></record> |
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subjects | Abdominal Surgery Aged Cardiac Surgery Delayed Gastric Emptying Esophagitis - etiology Female Fundoplication Gastrectomy - methods Gastroesophageal Reflux - complications Gastroesophageal Reflux - surgery Gastroparesis - complications Gastroparesis - surgery Gastroscopy General Surgery Hernia, Hiatal - surgery Herniorrhaphy Hiatus Hernia Hiatus Hernia Repair Humans Innovative Surgical Techniques Around the World Medicine Medicine & Public Health Middle Aged Quality of Life Short Gastric Vessel Sleeve Gastrectomy Surgery Thoracic Surgery Treatment Outcome Vascular Surgery |
title | Laparoscopic Partial Sleeve Gastrectomy with Fundoplication for Gastroesophageal Reflux and Delayed Gastric Emptying |
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