Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti · 2004
[Laparoscopic fundoplication. Indications and preoperative examinations].
Аннотация на английскомСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Drahonovský V, Kmet' L, Vrbenský L, Pecák P
Аннотация
AIM: The aim of this study is to assess success rates and risks of laparoscopic antireflux procedures, based on 2000 completed surgical procedures.
METHODOLOGY: We compared our experience with literature data. We concenterated on indications, preoperative examinations range and the procedure's technique itself.
RESULTS: It is advisable to indicate patients with already advanced disorders and hiatal hernias, after the procedure's principles and possible side-effects have been explained to them. It is also advisable to carefully indicate young, polymorbid and depressive patients. The higher the expertise of the operating team, the less contraindications for the procedure occur. The preoperative examination should be sufficient enough to exclude any diagnostic errors. Fibroscopy, preferably conducted repeatedly, is necessary. PH-metry and oesophageal manometry may aid to exclude incorrect indications and, on the contrary, may confirm the diagnosis in cases of non- typical clinical manifestations. Radiography may depict hernias, stenoses, the oesophagus length, its relation to the diaphragm.
CONCLUSION: The result of any antireflux surgical procedure depends on its correct indication, on a complete exhaustion of the patient's history data, on a rational assessment of the preoperative examination results. Education of the patient is necessary.
METHODOLOGY: We compared our experience with literature data. We concenterated on indications, preoperative examinations range and the procedure's technique itself.
RESULTS: It is advisable to indicate patients with already advanced disorders and hiatal hernias, after the procedure's principles and possible side-effects have been explained to them. It is also advisable to carefully indicate young, polymorbid and depressive patients. The higher the expertise of the operating team, the less contraindications for the procedure occur. The preoperative examination should be sufficient enough to exclude any diagnostic errors. Fibroscopy, preferably conducted repeatedly, is necessary. PH-metry and oesophageal manometry may aid to exclude incorrect indications and, on the contrary, may confirm the diagnosis in cases of non- typical clinical manifestations. Radiography may depict hernias, stenoses, the oesophagus length, its relation to the diaphragm.
CONCLUSION: The result of any antireflux surgical procedure depends on its correct indication, on a complete exhaustion of the patient's history data, on a rational assessment of the preoperative examination results. Education of the patient is necessary.