Abstract:
BACKGROUND:The selection of the type of fundoplication or the necessity for an added fundoplication after esophagomyotomy (Heller's operation) for the treatment of achalasia remains controversial. The present retrospective study was designed to compare the long-term results of total and partial fundoplication on the myotomized esophagus. METHODS:Between 1978 and 1998, a total of 64 consecutive patients with achalasia or diffuse esophageal spasm underwent esophagomyotomy and an antireflux operation via a left thoracotomy approach. Twenty-one had a total fundoplication (Nissen Group) during the period 1978-1983. After 1984 and until 1998, the remaining 43 patients were treated with addition of a Belsey Mark IV partial fundoplication (Belsey Group) to protect the myotomized esophagus. Clinical, radiologic, radionuclide transit, manometric, 24-h pH monitoring, and endoscopic assessments were obtained before and after the operation. RESULTS:There were no operative deaths or major complications in either group. After 6 years of follow-up the Belsey group was compared to the Nissen group. A higher frequency of dysphagia (7/18 versus 3/31; p=0.025), more barium stasis (9/13 versus 10/27; p=0.056), and increased radionuclide material retention (52.4% versus 29.2%; p=0.044) were observed in the Nissen group. These findings were confirmed by endoscopy, which showed increased esophageal lumen dilation (10/15 versus 8/26; p=0.026) and more frequent food retention (11/15 versus 6/26; p=0.002). Functionally, both operations successfully reduced the lower esophageal sphincter pressure gradient (from 23.8 to 7.7 mmHg for the Nissen group, and from 27.4 to 8.2 mmHg for the Belsey group; p=0.656). In the Nissen group, the esophageal diameter observed on radiology increased from 3.9 cm preoperatively to 5.5 cm postoperatively (p=0.012), whereas it remained identical for the Belsey group (ranging from 5.4 cm to 5.3 cm; p=0.695). Reoperation to relieve recurrent dysphagia and esophageal retention was necessary in 8 patients from the Nissen group and in 1 patient from the Belsey group (p<0.001). CONCLUSIONS:When treating achalasia or diffuse esophageal spasm by esophageal myotomy and an antireflux operation, a total fundoplication adds too much resistance to allow esophageal emptying and is considered as inappropriate. A partial fundoplication provides proper antireflux effects without causing significant esophageal emptying difficulties.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Zhu ZJ,Chen LQ,Duranceau Adoi
10.1007/s00268-007-9385-8subject
Has Abstractpub_date
2008-03-01 00:00:00pages
401-7issue
3eissn
0364-2313issn
1432-2323journal_volume
32pub_type
杂志文章abstract::Most people would agree that successful parathyroidectomy depends on two important variables: the surgeon's recognition and excision of the abnormal parathyroid gland(s) and the pathologist's confirmation that the removed tissue is parathyroid tissue. Frozen section is usually employed to confirm the identity of parat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680010218
更新日期:2000-11-01 00:00:00
abstract::There has been a long, unresolved debate regarding the operation of choice for well differentiated carcinoma of the thyroid. We therefore analyzed the feasibility, scope, sample size, and length of follow-up required to determine the optimal operation for papillary thyroid carcinoma. A statistical approach was used to...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s002689900016
更新日期:1996-01-01 00:00:00
abstract:: ...
journal_title:World journal of surgery
pub_type: 评论,信件
doi:10.1007/s00268-019-04919-x
更新日期:2019-04-01 00:00:00
abstract::In an attempt to prevent the sequelae of conventional gastrectomy, such as rapid gastric emptying, dumping syndrome, intestinal content reflux, indigestion, and poor absorption, we have devised the pylorus and pyloric vagus preserving gastrectomy (PPVPG). Experimenting on 48 dogs, we found theoretic grounds for using ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01655114
更新日期:1993-07-01 00:00:00
abstract:INTRODUCTION:Large incisional hernias with loss of domain (LIHLD) of the abdominal wall remain a therapeutic challenge due to the difficulty of replacing the contents of the hernia sac into the peritoneal cavity. Preoperative progressive pneumoperitoneum (PPP) is a valuable option. The purpose of this study was to eval...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3206-2
更新日期:2015-12-01 00:00:00
abstract::Intraabdominal bleeding, the most life-threatening complication following pancreaticoduodenectomy (PD), most often is associated with failure of a pancreaticojejunostomy anastomosis or with intraabdominal infection. We investigated whether placement of an omental flap around the splanchnic vessels in PD could reduce t...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7900-3
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Total thyroidectomy is a well-established surgical approach for the management of papillary thyroid cancer (PTC). However, the best surgical approach for papillary microcarcinoma is nowadays still debated. Both total thyroidectomy and simple lobectomy are used. We report the experience of a single University...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3327-7
更新日期:2016-03-01 00:00:00
abstract::Precise localization of cervical node metastasis of papillary thyroid carcinoma is rarely described. The aim of this retrospective study was to map their cervical involvement. Between 1974 and 1996 a series of 119 patients had total thyroidectomy with bilateral cervical lymph node dissection. Patients who had secondar...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900609
更新日期:1999-09-01 00:00:00
abstract::Radiologically demonstrable pancreatic endocrine tumors are a frequent requirement for exploration in patients with multiple endocrine neoplasia type I (MEN-I). Such delayed intervention is accompanied by a 30% to 50% incidence of pancreatic endocrine metastases. This study explores biochemical tumor markers and opera...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900451
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Splenic trauma is a common organ injury following blunt abdominal trauma. In order to establish the contemporary epidemiology of blunt splenic trauma in Scotland and to detect risk factors associated with patient outcomes, analysis of a multi-center database of trauma patients was performed. METHODS:The stu...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9218-9
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:It has been thirty years since Bianchi introduced the technique that made intestinal lengthening possible. The last three decades have seen lengthening procedures established as vital components of intestinal rehabilitation programs. The goal of the present study was to use a systematic literature review to ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-012-1879-3
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Routine preoperative staging in pancreas cancer is controversial. We sought to evaluate the rates of diagnostic laparoscopy (DLAP) for pancreatic cancer. METHODS:We queried the National Surgical Quality Improvement Program for patients with pancreas cancer (2005-2013) and compared groups who underwent DLAP,...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4855-8
更新日期:2019-03-01 00:00:00
abstract::Jaundice in patients of advanced carcinoma of the gallbladder requires palliation for the distressing symptoms of pruritus and cholangitis. Intrahepatic segment III duct cholangiojejunostomy is a means for alleviating the obstruction with malignant porta block. The authors reviewed their experience with this procedure...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900319
更新日期:1997-10-01 00:00:00
abstract::A marked change toward a more conservative approach in the treatment of abdominal trauma has been noted, especially during the last decade. This change in regimen was first seen in the handling of splenic trauma, initiated by pediatric surgeons. Later, the concept of conservative management was also introduced among a...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF01658672
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND:Intestinal ostomies are common surgical procedures performed in visceral surgery as part of management for several gastrointestinal diseases. This study aims to report the socio-demographic characteristics, indications and prognosis of intestinal ostomies in low-income country. METHODS:This was a 4-year ret...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4338-3
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the predictive value of the preoperative three-dimensional reconstructed volume (3D volumetry) for outcomes of laparoscopic splenectomy. The impact of splenomegaly on the feasibility of laparoscopic splenectomy is still debated. We hypothesized that splenic volumetry ma...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1789-4
更新日期:2013-01-01 00:00:00
abstract:INTRODUCTION:Mechanical bowel obstruction cases constitute an important place in emergency health care services. In this study, bowel obstructions caused by intra-abdominal tumors were compared with those without tumoral causes. PATIENTS AND METHODS:A total of 155 cases of mechanical bowel obstruction diagnosed were r...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0440-z
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Patients with end-stage renal disease (ESRD) and secondary hyperparathyroidism (SHPT) are at high risk of mortality. Whether an increased risk of death persists after a parathyroidectomy (PTX) is not clearly established. SUBJECTS AND METHODS:The survival of 40 patients with ESRD and SHPT who underwent PTX w...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0693-1
更新日期:2007-05-01 00:00:00
abstract::Despite a slow decline in the incidence of gastric cancer over the last 90 years, we can still expect to see over 100,000 patients die of this disease each decade in England and Wales. The 5-year survival rate has not improved during this century, which is largely due to the stage at diagnosis being unchanged. There a...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/BF00294709
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Few guidelines exist for the initial management of wounds in disaster settings. As wounds sustained are often contaminated, there is a high risk of further complications from infection, both local and systemic. Healthcare workers with little to no surgical training often provide early wound care, and where r...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-014-2663-3
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:The Lancet Commission on Global Surgery showed that countries with surgeon, anesthetist, and obstetrician (SAO) densities of 20-40 SAO/100,000 population were associated with improved health outcomes and recommended a global surgical workforce scale-up by 2030. Whether countries would be able to achieve such...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05329-9
更新日期:2020-04-01 00:00:00
abstract::Pepsinogen C is a proteolytic enzyme involved in the digestion of proteins in the stomach; it is also synthesized by a significant percentage of female breast carcinomas. In addition, it has been demonstrated that pepsinogen C is one of the few proteins induced by androgens in breast carcinoma cells. Here we evaluate ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00012325
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Molecular diagnostics can allow some patients with indeterminate thyroid nodule cytopathology to avoid diagnostic hemithyroidectomy; however, the testing is costly. We hypothesized that molecular testing with the intention of preventing unnecessary diagnostic hemithyroidectomy would be cost-effective if this...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05177-7
更新日期:2020-02-01 00:00:00
abstract::Extracorporeal life support has evolved considerably over the past two decades. Once considered as salvage or experimental therapy in adults, extracorporeal membrane oxygenation (ECMO) is evolving into a mainstream treatment for adult critical care. This is especially true in trauma and high-risk surgical patients, wh...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-016-3586-y
更新日期:2017-05-01 00:00:00
abstract::We sought to determine whether early eschar excision en masse (EEE) at one operation would be effective in the prevention and treatment of postburn organ dysfunction (OD) and multiple organ dysfunction syndrome (MODS). A total of 60 patients, with total body surface burned area over 35% and a third degree burn area ov...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900661
更新日期:1999-12-01 00:00:00
abstract:BACKGROUND:Enhanced recovery (ERAS) guidelines do not differentiate between left- and right-sided colectomies, but differences in recovery have been reported for the two procedure types. We aimed to compare compliance with the ERAS protocol and outcomes after right versus left colectomy. METHODS:Between June 2011 and ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3563-5
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Continuous vagal intraoperative neuromonitoring (CIONM) of the recurrent laryngeal nerve (RLN) may reduce the risk of RLN lesions during high-risk endocrine neck surgery such as operation for large goiter potentially requiring transsternal surgery, advanced thyroid cancer, and recurrence. METHODS:Fifty-five...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3368-y
更新日期:2016-03-01 00:00:00
abstract:INTRODUCTION:The role for diverting ostomy as a method to help reduce morbidity and mortality has been well established in the combat trauma population. However, factors that influence the type of ostomy used and which ostomies become permanent are poorly studied. We examine patterns of ostomy usage and reversal in a l...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4759-7
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to evaluate the efficacy of 10 % sucralfate ointment in the reduction of acute postoperative pain after open hemorrhoidectomy. METHODS:A total of 48 patients (24 men and 24 women) between 20 and 70 years of age who underwent open hemorrhoidectomy were included in this prospe...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-012-1805-8
更新日期:2013-01-01 00:00:00
abstract::From 1978 to 1989, 164 patients underwent hepatic resection for hepatocellular carcinoma at our institution. The carcinoma was resected completely in 149 patients. Sixteen patients were excluded from this study because it was not known whether they were recurrent or disease free, or because death occurred as a result ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01659099
更新日期:1993-11-01 00:00:00