Journal article
Laparoscopic wedge fundectomy for collis gastroplasty creation in patients with a foreshortened esophagus
Annals of surgery, v 260(6), pp 1030-1033
Dec 2014
PMID: 24487747
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To assess the outcome of a laparoscopic wedge-fundectomy Collis gastroplasty for a short esophagus during fundoplication and hiatal hernia repair.
The Collis gastroplasty provides a surgical solution for a foreshortened esophagus but has been associated with postoperative dysphagia and esophagitis.
We identified 150 patients who underwent a Collis gastroplasty from 1998 to 2012, and of these, 85 patients underwent laparoscopic procedures using the wedge-fundectomy technique.
The median age of the 85 patients (42 men/43 women) was 66 years (range, 37-84 years). A Nissen fundoplication was added to the Collis gastroplasty in 56 patients (66%) and a Toupet fundoplication in 29 patients. No patient had a staple line leak or abscess, and the median hospital stay was 3.5 days (interquartile range, 3-4.5 days). At a median follow-up of 12 months, 93% of patients were free of heartburn. Dysphagia was significantly less common after surgery (preoperative: 58% vs postoperative: 16%; P < 0.0001). New-onset dysphagia developed in only 2 patients. An upper endoscopy was performed in 54 patients at a median of 6 months after surgery, and erosions above the fundoplication were seen in 6 patients (11%). A small (1-2 cm) recurrent hernia was seen in 2 patients (2.4%).
The laparoscopic wedge-fundectomy Collis gastroplasty can be performed safely and is associated with a low prevalence of new-onset dysphagia and esophagitis. The addition of a Collis gastroplasty to an antireflux operation is an effective strategy in patients with short esophagus, and its more liberal use is encouraged.
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Details
- Title
- Laparoscopic wedge fundectomy for collis gastroplasty creation in patients with a foreshortened esophagus
- Creators
- Jörg Zehetner - University of Southern CaliforniaSteven R DeMeester - University of Southern CaliforniaShahin Ayazi - University of Southern CaliforniaPatrick Kilday - University of Southern CaliforniaEvan T Alicuben - University of Southern CaliforniaTom R DeMeester - University of Southern California
- Publication Details
- Annals of surgery, v 260(6), pp 1030-1033
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000345217200016
- Scopus ID
- 2-s2.0-84922319638
- Other Identifier
- 991022048375104721
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- Web of Science research areas
- Surgery