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[The "short esophagus problem" in laparoscopic anti-reflux surgery]
1Klinik für Allgemein- und Visceralchirurgie, Städtische Kliniken (Akademisches Lehrkrankenhaus der Universität Göttingen), Oldenburg. EKleimann@gmx.de
Summary
The Collis gastroplasty combined with Nissen fundoplication effectively treats shortened esophagus in patients undergoing laparoscopic antireflux surgery, relieving reflux and dysphagia symptoms. This procedure offers symptomatic relief for a complication of gastroesophageal reflux disease.
Area of Science:
- Gastroenterology
- Surgical Innovation
Background:
- Esophageal shortening affects 2-4% of GERD patients, complicating antireflux surgery.
- Shortened esophagus leads to tension during laparoscopic antireflux surgery, increasing failure rates and complications like recurrent hiatal hernia.
Observation:
- The Collis gastroplasty, an esophageal lengthening technique, was combined with Nissen fundoplication.
- This combined procedure creates an intraabdominal neoesophagus with a fundic wrap.
Findings:
- Five patients (2.0%) with shortened esophagus underwent laparoscopic antireflux surgery with Collis gastroplasty and Nissen fundoplication.
- All patients experienced significant relief from reflux and dysphagia symptoms post-operatively.
Implications:
- Collis gastroplasty with Nissen fundoplication is effective for intraoperatively diagnosed shortened esophagus during laparoscopic antireflux surgery.
- While effective for symptom relief, complete restitution is not achieved due to neoesophageal acid production and impaired clearance.