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Laparoscopic Partial Fundoplication in Case of Gastroesophageal Reflux Disease Patient with Absent Esophageal Motility.

Seo KW, Park MI, Yoon KY, Park SJ, Kim SE - J Gastric Cancer (2015)

Bottom Line: The surgical indications for the treatment of gastroesophageal reflux disease (GERD) in patients with esophageal motility disorders have been debated.After surgery, his subjective symptoms improved.Furthermore, objective findings including manometry and 24-hour pH-metry also improved.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Kosin University College of Medicine, Busan, Korea.

ABSTRACT
The surgical indications for the treatment of gastroesophageal reflux disease (GERD) in patients with esophageal motility disorders have been debated. We report a case of antireflux surgery performed in a patient with absent esophageal motility as categorized by the Chicago classification (2011). A 54-year-old man underwent laparoscopic Toupet fundoplication due to apparent GERD and desire to discontinue all medications. After surgery, his subjective symptoms improved. Furthermore, objective findings including manometry and 24-hour pH-metry also improved. In our experience, antireflux surgery can improve GERD symptoms patients, even with absent esophageal motility.

No MeSH data available.


Related in: MedlinePlus

pH metry conducted 24 hours postoperatively showing improved esophageal acidity during the resting period.
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Figure 5: pH metry conducted 24 hours postoperatively showing improved esophageal acidity during the resting period.

Mentions: After 6 months, the patient was subjected to EGD, 24-hour impedance pH monitoring, and esophageal HRM. EGD demonstrated absence of hiatal relaxation on the retroflexed view (Fig. 2B). Esophageal HRM still showed absent peristalsis of the distal esophagus. Mean DCI after operation was also remained at zero. However, LES pressure increased from 10.5 to 14.3 mmHg and IRP also increased from 6.6 to 12.2 mmHg (Table 1). The 24-hour pH monitoring revealed increased esophageal acidity during the resting period. All reflux distal episode was observed less frequently (4 times compared to 79 times). All reflux percent times normalized to 0.0% from 5.3% and the DeMeester score reduced to 0.8 from 82.6 (Table 1, Fig. 5). Manometric and pH-metric differences before and after surgery are summarized in Table 1. At 14 months after the operation, the typical symptoms were improved compared to those prior to surgery and the patient remained off all medications. He felt symptoms only 3 or 4 times per week. He did not report dysphagia and had no difficulties with belching but did occasionally complain of mild symptoms of bloating and flatulence.


Laparoscopic Partial Fundoplication in Case of Gastroesophageal Reflux Disease Patient with Absent Esophageal Motility.

Seo KW, Park MI, Yoon KY, Park SJ, Kim SE - J Gastric Cancer (2015)

pH metry conducted 24 hours postoperatively showing improved esophageal acidity during the resting period.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4496439&req=5

Figure 5: pH metry conducted 24 hours postoperatively showing improved esophageal acidity during the resting period.
Mentions: After 6 months, the patient was subjected to EGD, 24-hour impedance pH monitoring, and esophageal HRM. EGD demonstrated absence of hiatal relaxation on the retroflexed view (Fig. 2B). Esophageal HRM still showed absent peristalsis of the distal esophagus. Mean DCI after operation was also remained at zero. However, LES pressure increased from 10.5 to 14.3 mmHg and IRP also increased from 6.6 to 12.2 mmHg (Table 1). The 24-hour pH monitoring revealed increased esophageal acidity during the resting period. All reflux distal episode was observed less frequently (4 times compared to 79 times). All reflux percent times normalized to 0.0% from 5.3% and the DeMeester score reduced to 0.8 from 82.6 (Table 1, Fig. 5). Manometric and pH-metric differences before and after surgery are summarized in Table 1. At 14 months after the operation, the typical symptoms were improved compared to those prior to surgery and the patient remained off all medications. He felt symptoms only 3 or 4 times per week. He did not report dysphagia and had no difficulties with belching but did occasionally complain of mild symptoms of bloating and flatulence.

Bottom Line: The surgical indications for the treatment of gastroesophageal reflux disease (GERD) in patients with esophageal motility disorders have been debated.After surgery, his subjective symptoms improved.Furthermore, objective findings including manometry and 24-hour pH-metry also improved.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Kosin University College of Medicine, Busan, Korea.

ABSTRACT
The surgical indications for the treatment of gastroesophageal reflux disease (GERD) in patients with esophageal motility disorders have been debated. We report a case of antireflux surgery performed in a patient with absent esophageal motility as categorized by the Chicago classification (2011). A 54-year-old man underwent laparoscopic Toupet fundoplication due to apparent GERD and desire to discontinue all medications. After surgery, his subjective symptoms improved. Furthermore, objective findings including manometry and 24-hour pH-metry also improved. In our experience, antireflux surgery can improve GERD symptoms patients, even with absent esophageal motility.

No MeSH data available.


Related in: MedlinePlus