[Cuffing of the distal esophagus in the treatment of gastroesophageal reflux].
This technique was derived from Nissen-Rossetti's fundoplication operation. Anatomical bases for the method are described which allow the simple performance of a regulated and measured version (in spite of regional anatomical variations), that is non-calibrating (to avoid exposure to conventional sequelae of fundal plication) and reproducible (essential when comparing results assessed for global series). Technical features are described in detail and discussed, while emphasizing the importance of the following rules; respect of regional fascial structures, avoidance of vagal trunks, observation of the compliance of the gastrosplenic omentum and conformation of the gastrophrenic ligament to allow simple mobilization of the anterior and posterior hemivalves. A summarized report on 295 operations, performed on and 233 patients reviewed after 3 to 9 years, indicates low mortality (1.35% from complications arising from patients' condition generally), an acceptable morbidity (5.5% of complications requiring lengthened hospital stay) and very correct long-term results (no "gas bloat syndrome", 8 dysphagias, 15 radiologic and/or endoscopic recurrences including 11 cases with clinical evidence of recurrence of reflux). The fact that distal esophageal cuffing can be adapted for cases of hiatus hernia, of peptic stenosis of esophagus, of undroppable cardia, and of associated duodenal ulcer or bile calculi suggests its use as a routine operation, if possible at an early stage, for all cases of pathologic gastroesophageal reflux.
D004947:Esophagus / Q000601:surgery*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D008722:Methods; D011183:Postoperative Complications; D012008:Recurrence; D013997:Time Factors
Le manchonnage de l'oesophage distal dans le traitement du reflux gastro-oesophagien.