1.Factors predicting outcomes of laparoscopic Nissen fundoplication for gastroesophageal reflux disease: experience at a single institution in Korea.
Joong Min PARK ; Beom Jin KIM ; Jae Gyu KIM ; Kyong Choun CHI
Annals of Surgical Treatment and Research 2017;92(4):184-190
PURPOSE: Laparoscopic fundoplication is considered the standard surgical treatment for gastroesophageal reflux disease (GERD) in Western countries. However, some patients experience poor surgical outcomes with this procedure. The study aimed to identify the predictive factors of the surgical outcomes of laparoscopic Nissen fundoplication for the treatment of Korean GERD patients. METHODS: Sixty-one patients with GERD were treated using laparoscopic Nissen fundoplication between November 2012 and February 2015. Symptom control rates were compared according to clinical and surgical factors to identify predictive factors of successful surgical outcomes. RESULTS: Thirty-five men and 26 women were enrolled. Preoperatively, typical symptoms were present in 60 patients (98%), while atypical symptoms were present in 40 patients (66%). Postoperatively, typical symptoms were controlled in 51 of 60 patients (85.0%), while atypical symptoms were controlled in 33 of 40 patients (82.5%). Overall, at 6 months postsurgery, 54 (88.5%) reported some resolution of GERD symptoms, with 48 (78.7%) achieving complete control. Patients who exhibited a good response to proton pump inhibitor therapy had a significantly greater rate of complete symptom control (P = 0.035). CONCLUSION: Laparoscopic fundoplication is effective for controlling GERD symptoms. Response to preoperative proton pump inhibitor was a predictor of successful outcome.
Female
;
Fundoplication*
;
Gastroesophageal Reflux*
;
Humans
;
Korea*
;
Laparoscopy
;
Male
;
Proton Pumps
2.Comparison between Laparoscopic and Open Nissen Fundoplication in Pediatric Patients.
Hong Ki GWAK ; Soo Min JUNG ; Suk Koo LEE ; Jeong Meen SEO
Journal of the Korean Association of Pediatric Surgeons 2012;18(2):59-67
Fundoplication is a common surgical procedure for gastroesophageal reflux Disease (GERD). Recently the procedure has been performed with increased frequency laparoscopically. The aim of this study is to compare laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF) for GERD in children. We studied retrospectively the 88 pediatric patients who underwent the Nissen fundoplication for GERD as primary antireflux surgery from 1994 and 2009. ONF was performed in 34 cases and LNF was in 54 cases. 58 patients have neurologic impairment. Time to initial food intake after the surgery were reduced in the LNF group (p = 0.032).Recurrent GERD symptom occurred in one patient in LNF group and four patients in ONF group within 1 year after the surgery (p = 0.012). There were no statistically significant differences in post operative morbidity and mortality between both groups. In conclusion, our practice of Nissen fundoplication indicates that LNF takes priority in most pediatric patients.
Child
;
Eating
;
Fundoplication
;
Gastroesophageal Reflux
;
Humans
;
Laparoscopy
;
Retrospective Studies
3.Endoscopic Treatment of Refractory Gastroesohageal Reflux Disease.
Won Hee KIM ; Pil Won PARK ; Ki Baik HAHM ; Sung Pyo HONG
Clinical Endoscopy 2013;46(3):230-234
Though efficient acid suppression with proton pump inhibitors (PPIs) remains the mainstay of treatment of gastroesophageal reflux disease (GERD), some of the patients showed refractory response to PPIs, necessitating further intervention. After increasing dose of PPIs and other kinds of pharmacological intervention adopting prokinetics or others, variable endoscopic treatments are introduced for the treatment of these refractory cases. The detailed introduction regarding endoscopic treatment for GERD is forwarded in this review article. Implantation of reabsorbable or synthetic materials in the distal esophagus was tried in vain and is expelled from the market due to limited efficacy and serious complication. Radiofrequency energy delivery (Stretta) and transoral incisionless fundoplication (EsophyX) are actively tried currently.
Esophagus
;
Fundoplication
;
Gastroesophageal Reflux
;
Humans
;
Proton Pump Inhibitors
4.Nationwide survey of partial fundoplication in Korea: comparison with total fundoplication.
Chang Min LEE ; Joong Min PARK ; Han Hong LEE ; Kyong Hwa JUN ; Sungsoo KIM ; Kyung Won SEO ; Sungsoo PARK ; Jong Han KIM ; Jin Jo KIM ; Sang Uk HAN
Annals of Surgical Treatment and Research 2018;94(6):298-305
PURPOSE: Laparoscopic total fundoplication is the standard surgery for gastroesophageal reflux disease. However, partial fundoplication may be a viable alternative. Here, we conducted a nationwide survey of partial fundoplication in Korea. METHODS: The Korean Anti-Reflux Surgery study group recorded 32 cases of partial fundoplication at eight hospitals between September 2009 and January 2016. The surgical outcomes and postoperative adverse symptoms in these cases were evaluated and compared with 86 cases of total fundoplication. RESULTS: Anterior partial fundoplication was performed in 20 cases (62.5%) and posterior in 12 (37.5%). In most cases, partial fundoplication was a secondary procedure after operations for other conditions. Half of patients who underwent partial fundoplication had typical symptoms at the time of initial diagnosis, and most of them showed excellent (68.8%), good (25.0%), or fair (6.3%) symptom resolution at discharge. Compared to total fundoplication, partial fundoplication showed no difference in the resolution rate of typical and atypical symptoms. However, adverse symptoms such as dysphagia, difficult belching, gas bloating and flatulence were less common after partial fundoplication. CONCLUSION: Although antireflux surgery is not popular in Korea and total fundoplication is the primary surgical choice for gastroesophageal reflux disease, partial fundoplication may be useful in certain conditions because it has less postoperative adverse symptoms but similar efficacy to total fundoplication.
Deglutition Disorders
;
Diagnosis
;
Eructation
;
Flatulence
;
Fundoplication*
;
Gastroesophageal Reflux
;
Humans
;
Korea*
5.Laparoscopic Hiatal Hernia Repair during Laparoscopic Roux-en-Y Gastric Bypass (LRYGB).
Hong Chan LEE ; In Soo PARK ; Eung Kook KIM
Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons 2009;12(2):147-149
Obesity is one of the most significant causes of GERD. Nissen fundoplication is a surgical procedure that's performed world widely for treating patients with GERD and a hiatal hernia and who are intractable to medical therapy. However, Nissen fundoplication may have technical difficulties in morbidly obese patients due to the huge perigastric, intraabdominal fat tissue and hepatomegaly. During the laparoscopic Roux-en-Y Gastric Bypass (LRYGB) procedure, the stomach was divided into the gastric pouch and the remnant stomach by vertiacally stapling at the angle of His. The posterior gastric wall and hiatus were easily exposed even when there was huge deposits of perigatric and intraabdominal fat tissue. We report here on a case of concomitant hiatal hernia repair with LRYGB in a morbidly obese patient.
Fundoplication
;
Gastric Bypass
;
Gastric Stump
;
Gastroesophageal Reflux
;
Hepatomegaly
;
Hernia, Hiatal
;
Humans
;
Obesity
;
Obesity, Morbid
;
Stomach
6.Laparoscopic Nissen Fundoplication and Collis Gastroplasty.
Sang Yun SONG ; Jeong Min PARK ; In Suk JUNG ; Byung Hee ANH ; Kook Ju NA
The Korean Journal of Thoracic and Cardiovascular Surgery 2006;39(9):733-738
The prevalence of gastroesophageal reflux disease has been increased recently in Korea. The use of minimally invasive laparoscopic and thoracoscopic surgery has become popular in the operation of esophageal disease such as esophageal cancer or gastroesophageal reflux disorder. We experienced three cases of laparoscopic Nissen fundoplications and one case of laparoscopic Collis gastroplasty, and we will describe the technical aspect of these surgeries.
Esophageal Diseases
;
Esophageal Neoplasms
;
Fundoplication*
;
Gastroesophageal Reflux
;
Gastroplasty*
;
Korea
;
Laparoscopes
;
Prevalence
;
Thoracoscopy
7.Upper Gastrointestinal Cancer and Reflux Disease.
Journal of Gastric Cancer 2013;13(2):79-85
There is a growing evidence that gastroesophageal reflux disease is related to several upper gastrointestinal cancers, mainly the esophageal adenocarcinoma and a certain type of gastric cardia adenocarcinoma. Currently, the incidence of gastroesophageal reflux disease is rapidly increasing in Korea. Therefore, there is a possibility of such increasing cancerous incidents, similar to the western worlds. In this article, the relationship between gastroesophageal reflux disease and several upper gastrointestinal cancers, the components of refluxate which has possible causal relationship with carcinogenesis, and the clinical implications of such relationship in the management of gastroesophageal reflux disease patients are discussed through the review of literature.
Adenocarcinoma
;
Cardia
;
Fundoplication
;
Gastroesophageal Reflux
;
Gastrointestinal Neoplasms
;
Humans
;
Incidence
;
Korea
;
Western World
8.A Case of Gas-Bolat Syndrome.
Chi Wook SONG ; Sung Joon LEE ; Chang Duck KIM ; Ho Sang RYU ; Jin Hai HYUN ; Kwang Taik LEE ; Byung Won HUR ; Hye Rang KIM
Korean Journal of Gastrointestinal Motility 1999;5(1):39-43
Gas-bloat syndrome is a characteristic disease that developed in patients who had symptoms severe enough to warrant surgery for refractory refiux esophagitis. During the first few months, most of patients have significant symptoms and gradually have been improved except some cases. Although the underlying pathophysiology is uncatain, too tense fundoplication could result in an one-way valve peventing most patients from belching or vomiting. This syndrome has been reported in western country for many years but not yet in Korea. We report a case of gas-bloat syndrome after fundoplication for sevete reflux esophagitis and hiatal hemia.
Eructation
;
Esophagitis
;
Esophagitis, Peptic
;
Fundoplication
;
Gastroesophageal Reflux
;
Humans
;
Korea
;
Transcutaneous Electric Nerve Stimulation
;
Vomiting
9.Early experiences of minimally invasive surgery to treat gastroesophageal reflux disease.
Sae Byul LEE ; Kyoung Mo JEON ; Beom Su KIM ; Kab Choong KIM ; Hwoon Yong JUNG ; Youn Baik CHOI
Journal of the Korean Surgical Society 2013;84(6):330-337
PURPOSE: There are fewer patients with gastroesophageal reflux disease (GERD) in Korea compared with Western countries. The incidence of GERD has increased in recent years however, concerning many physicians. Here, we report our early experiences of using a recently introduced method of laparoscopic antireflux surgery for the treatment of GERD in Korean patients. METHODS: Fifteen patients with GERD were treated using antireflux surgery between May 2009 and February 2012 at the University of Ulsan College of Medicine and Asan Medical Center. Laparoscopic Nissen fundoplication with 360degrees wrapping was performed on all patients. RESULTS: Eleven male and four female patients were evaluated and treated with an average age of 58.1 +/- 14.1 years. The average surgical time was 118.9 +/- 45.1 minutes, and no complications presented during surgery. After surgery, the reflux symptoms of each patient were resolved; only two patients developed transient dysphagia, which resolved within one month. One patient developed a 6-cm hiatal hernia that had to be repaired and reinforced using mesh. CONCLUSION: The use of laparoscopic surgery for the treatment of GERD is safe and feasible. It is also an efficacious method for controlling the symptoms of GERD in Korean patients. However, the use of this surgery still needs to be standardized (e.g., type of surgery, bougienage size, wrap length) and the long-term outcomes need to be evaluated.
Deglutition Disorders
;
Female
;
Fundoplication
;
Gastroesophageal Reflux
;
Hernia, Hiatal
;
Humans
;
Incidence
;
Korea
;
Laparoscopy
;
Male
;
Operative Time
10.Various Laparoscopic Surgery Using da VinciTM Robotic System in Pig Mode Pilot Study.
Journal of the Korean Surgical Society 2002;63(3):175-178
PURPOSE: To evaluate the feasibility of a currently available robotic surgical system in performing various general surgical laparoscopic procedures in an acute porcine model. METHODS: Telepresence robotic laparoscopic surgeries, comprising cholecystectomy, Nissen-fundoplication, choledochocholedochostomy and gastrojejunostomy were performed in 5 swine models for 3 consecutive days by the same surgeon who is experienced in advanced conventional laparoscopic surgery. Data were collected from the da VinciTM Robotic System. RESULTS: Mean operative times were 24.4+/-10.6 minutes for cholecystectomy (N=5) 41.2+/-5.5 for Nissen fundoplication (N=5) 51+/-5.6 for choledochocholedochostomy (N=5), and 53.3+/-7.6 for gastrojejunostomy (N=3) but there were 2 cases of failure in the latter. In the case of choledochocholedochostomy, operative time was reduced from 76 minutes in the first case to 42 minutes in the last. Intra- operative blood loss was minimal and there was no intra- operative complication related with malfunction of robotic system. CONCLUSION: Robotic laparoscopic procedures can be performed effectively using the da VinciTM System. In this limited study, the learning curve and operative times were shorter with the da VinciTM System, and the intraoperative technical movements appeared inherently more intuitive. Additional chronic study comparing conventional laparoscopic with robotic surgery is mandatory.
Cholecystectomy
;
Fundoplication
;
Gastric Bypass
;
Laparoscopy*
;
Learning Curve
;
Operative Time
;
Pilot Projects*
;
Swine