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A Hill Gastropexy Combined with Nissen Fundoplication Appears Equivalent to a Collis-Nissen in the Management of Short Esophagus
Ist Teil von
Journal of gastrointestinal surgery, 2018-03, Vol.22 (3), p.389-395
Ort / Verlag
New York: Springer US
Erscheinungsjahr
2018
Link zum Volltext
Quelle
SpringerLink
Beschreibungen/Notizen
Introduction
A Collis gastroplasty combined with a Nissen fundoplication is commonly used when a shortened esophagus is encountered. An alternative combines intra-abdominal fixation of the gastroesophageal junction via a Hill gastropexy with a Nissen fundoplication to maintain length and avoid juxtaposing acid-secreting tissue against the diseased esophagus.
Methods
A retrospective case-controlled analysis of 106 consecutive patients with short esophagus undergoing Hill-Nissen (HN) or Collis-Nissen (CN) was compared to a cohort of 105 matched patients without short esophagus undergoing primary Nissen fundoplication (NF).
Results
At a median follow-up of 27 months, all groups (HN:CN:NF) improved significantly over preoperative baseline with no differences in overall complications (18 vs 16 vs 19%,
p
= 0.78), DeMeester score (11.1 vs 19.1 vs 14.2,
p
= 0.49), postoperative PPI use (16 vs 22 vs 15%,
p
= 0.24), anatomic recurrences (11.7 vs 5.5 vs 7%,
p
= 0.43), or quality of life (6.8 vs 6.7 vs 6.4,
p
= 0.3).
Conclusions
The management of shortened esophagus with Hill-Nissen is safe and as effective as Collis gastroplasty with Nissen fundoplication. Both options appear to produce similar outcomes to patients requiring only a Nissen fundoplication suggesting a shortened esophagus does not beget an inferior outcome.