title: Endoscopic appraisal of the gastroesophageal valve after antireflux surgery.
abstract: OBJECTIVE
  Little consensus exists regarding the endoscopic assessment of the esophagogastric junction after antireflux surgery. The purpose of this report is to characterize the gastroesophageal valve appearance unique to each type of antireflux procedure and to introduce an endoscopic lexicon by which to describe this anatomic region.
  
  
  METHODS
  Endoscopic images were obtained from patients who had undergone any one of the following procedures: Nissen, Collis-Nissen, Toupet, and Dor fundoplications and Hill repair. Images were excluded if patients had any symptoms of heartburn, regurgitation, dysphagia, chest pain, or gas bloat or if they were using antisecretory medication. Seven photographs per operation type were evaluated by experienced surgeons and gastroenterologists tasked with describing defining characteristics of each procedure.
  
  
  RESULTS
  Ten valve criteria were developed to uniquely identify and quantify the ideal endoscopic appearance of each procedure. Illustrations were created to clearly depict those traits.
  
  
  CONCLUSIONS
  Using 10 gastroesophageal valve criteria, the key components of a successful functional repair of the esophagogastric junction were defined. These criteria can be employed when evaluating upper gastrointestinal complaints after antireflux surgery and may ultimately serve as a dependable outcome measure.
authors.affiliation: Department of Surgery, Oregon Health and Science University, Portland, Oregon, USA.
authors.forename: Blair A
authors.initials: BA
authors.lastname: Jobe
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kahrilas
authors.forename: Ashley H
authors.initials: AH
authors.lastname: Vernon
authors.forename: Corinne
authors.initials: C
authors.lastname: Sandone
authors.forename: Deepak V
authors.initials: DV
authors.lastname: Gopal
authors.forename: Lee L
authors.initials: LL
authors.lastname: Swanstrom
authors.forename: Ralph W
authors.initials: RW
authors.lastname: Aye
authors.forename: Lucius D
authors.initials: LD
authors.lastname: Hill
authors.forename: John G
authors.initials: JG
authors.lastname: Hunter
mesh_terms: D004943:Esophagogastric Junction / Q000473:pathology / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods*; D018662:Fundoplication / Q000379:methods*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D011184:Postoperative Period; D016896:Treatment Outcome