[Results of the celioscopic modification of Hill's operation (HMC). Apropos of an experience of 50 cases].
The objective of this study was to evaluate the clinical, endoscopic and manometric results of modified Hill's operation performed by laparoscopy. Between may 1991 and december 1992, 50 symptomatic patients (27 males and 23 females, mean age: 47 +/- 15.3 years, mean weight: 74.5 +/- 12.6 kg) were operated by laparoscopic modified Hill's operation. Gastro-oesophageal endoscopy and oesophageal manometry (25 cases) were performed preoperatively and postoperatively. The patients were interviewed by an independent observer with a mean follow-up of 8 +/- 4.9 months after the operation. Preoperatively, the mucosal cardia was situated 36 cm from the dental arch (range: 30-43), 29 patients presented with ulcerated oesophagitis refractory to treatment (58%), while the mean resting pressure of the lower oesophageal sphincter was 7.24 +/- 4.93 mmHg. After introduction of the laparoscope and insertion of the various trocars, the operation consisted of dissecting the hiatal orifice, posterior myorrhaphy of the diaphragmatic crura, suture of the right border of the oesophagus to the diaphragmatic crura and closure of the angle of His. This antireflux device was completed by an anterior hemivalve, fixed to the left and right crura. Postoperatively, the mucosal cardia was situated 39.8 cm from the dental arch (range: 35-45) and only one case of oesophagitis persisted (3.4%). The mean resting pressure of the lower oesophageal sphincter was significantly increased to 18.5 +/- 6.86 mmHg (p < 0.001). The mean duration of anaesthesia and the mean operating time were 116 +/- 45 min and 92 +/- 40 min, respectively. The mean hospital stay was 6 +/- 2.3 days.(ABSTRACT TRUNCATED AT 250 WORDS)
Fromont
G
G
Polyclinique Bois-Bernard, CHRU, Lille, France.
Leroy
J
J
Guillemot
F
F
Courtade
A
A
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D011859:Radiography
Résultats de l'intervention de Hill modifiée coelioscopique (HMC). A propos d'une expérience de 50 cas.