{"id":89258,"date":"2022-10-18T08:09:07","date_gmt":"2022-10-18T08:09:07","guid":{"rendered":"https:\/\/kellumphysicianpartners.com\/?p=89258"},"modified":"2022-10-18T08:15:31","modified_gmt":"2022-10-18T08:15:31","slug":"gastrojejunostomy-for-the-treatment-of-gastro-3","status":"publish","type":"post","link":"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/","title":{"rendered":"Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures"},"content":{"rendered":"Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures<\/title><\/p>\n<p>Grover and you may Kothari (2015) reported that diligent satisfaction which have number one anti-reflux functions was high, however, a small percentage away from clients feel recurrent reflux and you can dysphagia, demanding re-operation. The big anatomic causes of hit a brick wall fundoplication try slipped fundoplication, incapacity to recognize an initial esophagus, and you can complications with the fresh new wrap. Minimally intrusive businesses might usual <a href=\"https:\/\/datingranking.net\/cs\/blackdatingforfree-recenze\/\">datingranking.net\/cs\/blackdatingforfree-recenze\/<\/a> of these methods. Options for procedures were upgrade fundoplication that have hiatal hernia fix in the event that requisite, conversion process so you’re able to RNY physiology, otherwise, because the a past resort, esophagectomy. Which review don’t give people clinical data; but not, it did cite the research from the Awais ainsi que al (2008) and you will Makris ainsi que al (2012).<!--more--><\/p>\n<h2>The brand new authors said that conversion in order to RNY structure got a leading success rate, making this strategy an important option regarding safely chosen patient<\/h2>\n<p>Awais and co-workers (2008) stated that intractable GERD after prior anti-reflux operation presents a difficult challenge. These investigators examined the role of Roux-en-Y near esophago-jejunostomy (RNYNEJ) in the management of intractable reflux symptoms after prior anti-reflux surgery. Between , a total of 25 patients with GERD after anti-reflux surgery underwent RNYNEJ. The end-points evaluated were improvement in GERD symptoms using the GERD-Health Related Quality of Life (HRQL) scale, overall patient satisfaction, overall patient weight loss, and improvement of co-morbid conditions. There were 4 men and 21 women (mean age of 51 years; range of 35 to 74); 72 % had a BMI of greater than 30; 44 % had more than 1 anti-reflux surgery and 40 % had a previous Collis gastroplasty. The peri-operative mortality was 0 %; 6 patients (24 %) developed major post-operative complications, including anastomotic leak (n = 2) and Roux-limb obstruction (n = 1). The median length of stay (LOS) was 6 days; 80 % of the patients reported satisfaction at mean follow-up time of 16.5 months. Their BMI reduced from 35.8 to 27.7 (p < 0.001); 73 % of co-morbid conditions were improved and the GERD HRQL score improved from 29.9 to 7.3 (p < 0.001). The authors concluded that the RNYNEJ for persistent GERD after prior anti-reflux surgery was technically challenging with significant morbidity. However, the majority of the patients reported satisfaction with significant improvement in symptoms. Many patients had associated benefits of weight loss and improvement in co-morbid conditions. They stated that RNYNEJ should be considered as an important option for the treatment of intractable GERD after prior anti-reflux surgery, particularly in the obese. Moreover, they stated that there is a need to further investigate and analyze patient variables that influence outcomes because this may help physicians\/surgeons to better select patients for a particular type of operation. They noted that these variables need to be prospectively studied to define optimal candidates, and further work is needed for optimizing patient selection. This was a small study (n = 25) with short-term follow-up (mean of 16.5 months).<\/p>\n<h2>There was an increase in reported nausea (0-1, p < 0<\/h2>\n<p>Makris and colleagues (2012) stated that revisionary fundoplication is the mainstay of treatment for failed previous fundoplication, but is not always feasible. These investigators reported their experience with use of short-limb RNY reconstruction for failed anti-reflux procedures. Prospectively collected data were retrospectively analyzed for morbidity, mortality, pre- and post-procedure symptom scores (scale 0 to 3), BMI, and patient satisfaction (scale 1 to 10). A total of 72 patients with 1 to 4 (median 1) previous anti-reflux procedures underwent RNY reconstruction, either to gastric pouch (n = 64) or to the esophagus (n = 8). There were 37 laparoscopic, 24 open abdominal, and 2 combined thoracic-abdominal procedures; 9 additional patients underwent conversion from laparoscopy to open surgery. Mean follow-up of 20.7 months (\u00b1 12.9 months) was available in 63 (88 %) patients. The overall median scores for heart-burn, regurgitation, dysphagia, chest pain, and nausea were 0 or 1. There were 72 major and minor complications noted that affected 33 (46 %) patients, with no in-hospital or 30-day mortality observed. The most common complications were anastomotic strictures, bowel obstructions, respiratory complications, and dumping. Mean post-operative BMI was 24.6 (\u00b1 4.4) kg\/m(2) compared with pre-operative BMI of 31.4 (\u00b1 6.1) kg\/m(2). Mean reported satisfaction score was 8.2 (\u00b1 2.1), and 89 % of the patients would recommend the procedure to a friend. Pre- and post-operative symptoms could be compared in 57 patients, and significant decrease in median symptom scores for heart-burn (2-0, p < 0.05), regurgitation (1-0, p < 0.05), and dysphagia (2-0, p < 0.05) was confirmed. 05). The authors concluded that short-limb RNY reconstruction was an effective remedial procedure for a subset of patients with failed anti-reflux surgery, but morbidity was significant. Moreover, they stated that the main drawback of this study was retrospective studies performed on prospective databases. Furthermore, they stated that studies with longer follow-up are needed to validate these findings.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures<\/p>\n<p>Grover and you may Kothari (2015) reported that diligent satisfaction which have number one anti-reflux functions was high, however, a small percentage away from clients feel recurrent reflux and you can dysphagia, demanding re-operation. The big anatomic causes of hit a brick wall fundoplication try slipped fundoplication, incapacity to recognize an initial esophagus, and you can complications with the fresh new wrap.<\/p>\n<p><a href=\"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/\" class=\"more-link\" title=\"Read Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures\">Read More »<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6108],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v19.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures - Kellum Physician Partners<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures - Kellum Physician Partners\" \/>\n<meta property=\"og:description\" content=\"Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures Grover and you may Kothari (2015) reported that diligent satisfaction which have number one anti-reflux functions was high, however, a small percentage away from clients feel recurrent reflux and you can dysphagia, demanding re-operation. The big anatomic causes of hit a brick wall fundoplication try slipped fundoplication, incapacity to recognize an initial esophagus, and you can complications with the fresh new wrap.Read More »\" \/>\n<meta property=\"og:url\" content=\"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/\" \/>\n<meta property=\"og:site_name\" content=\"Kellum Physician Partners\" \/>\n<meta property=\"article:published_time\" content=\"2022-10-18T08:09:07+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2022-10-18T08:15:31+00:00\" \/>\n<meta name=\"author\" content=\"kellum\" \/>\n<meta name=\"twitter:card\" content=\"summary\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"kellum\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebSite\",\"@id\":\"https:\/\/kellumphysicianpartners.com\/#website\",\"url\":\"https:\/\/kellumphysicianpartners.com\/\",\"name\":\"Kellum Physician Partners\",\"description\":\"\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/kellumphysicianpartners.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/\",\"url\":\"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/\",\"name\":\"Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures - Kellum Physician Partners\",\"isPartOf\":{\"@id\":\"https:\/\/kellumphysicianpartners.com\/#website\"},\"datePublished\":\"2022-10-18T08:09:07+00:00\",\"dateModified\":\"2022-10-18T08:15:31+00:00\",\"author\":{\"@id\":\"https:\/\/kellumphysicianpartners.com\/#\/schema\/person\/c2cac49f887cce9462fdf9e53a2395bf\"},\"breadcrumb\":{\"@id\":\"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/kellumphysicianpartners.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures\"}]},{\"@type\":\"Person\",\"@id\":\"https:\/\/kellumphysicianpartners.com\/#\/schema\/person\/c2cac49f887cce9462fdf9e53a2395bf\",\"name\":\"kellum\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/kellumphysicianpartners.com\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/7a2f1526de045c827ee8c170dcb95c5c?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/7a2f1526de045c827ee8c170dcb95c5c?s=96&d=mm&r=g\",\"caption\":\"kellum\"},\"url\":\"https:\/\/kellumphysicianpartners.com\/author\/kellum\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures - Kellum Physician Partners","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/","og_locale":"en_US","og_type":"article","og_title":"Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures - Kellum Physician Partners","og_description":"Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures Grover and you may Kothari (2015) reported that diligent satisfaction which have number one anti-reflux functions was high, however, a small percentage away from clients feel recurrent reflux and you can dysphagia, demanding re-operation. The big anatomic causes of hit a brick wall fundoplication try slipped fundoplication, incapacity to recognize an initial esophagus, and you can complications with the fresh new wrap.Read More »","og_url":"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/","og_site_name":"Kellum Physician Partners","article_published_time":"2022-10-18T08:09:07+00:00","article_modified_time":"2022-10-18T08:15:31+00:00","author":"kellum","twitter_card":"summary","twitter_misc":{"Written by":"kellum","Est. reading time":"4 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebSite","@id":"https:\/\/kellumphysicianpartners.com\/#website","url":"https:\/\/kellumphysicianpartners.com\/","name":"Kellum Physician Partners","description":"","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/kellumphysicianpartners.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/","url":"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/","name":"Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures - Kellum Physician Partners","isPartOf":{"@id":"https:\/\/kellumphysicianpartners.com\/#website"},"datePublished":"2022-10-18T08:09:07+00:00","dateModified":"2022-10-18T08:15:31+00:00","author":{"@id":"https:\/\/kellumphysicianpartners.com\/#\/schema\/person\/c2cac49f887cce9462fdf9e53a2395bf"},"breadcrumb":{"@id":"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/kellumphysicianpartners.com\/2022\/10\/gastrojejunostomy-for-the-treatment-of-gastro-3\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/kellumphysicianpartners.com\/"},{"@type":"ListItem","position":2,"name":"Gastrojejunostomy for the treatment of Gastro-Esophageal Reflux Disease adopting the Anti-Reflux Procedures"}]},{"@type":"Person","@id":"https:\/\/kellumphysicianpartners.com\/#\/schema\/person\/c2cac49f887cce9462fdf9e53a2395bf","name":"kellum","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/kellumphysicianpartners.com\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/7a2f1526de045c827ee8c170dcb95c5c?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/7a2f1526de045c827ee8c170dcb95c5c?s=96&d=mm&r=g","caption":"kellum"},"url":"https:\/\/kellumphysicianpartners.com\/author\/kellum\/"}]}},"_links":{"self":[{"href":"https:\/\/kellumphysicianpartners.com\/wp-json\/wp\/v2\/posts\/89258"}],"collection":[{"href":"https:\/\/kellumphysicianpartners.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/kellumphysicianpartners.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/kellumphysicianpartners.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/kellumphysicianpartners.com\/wp-json\/wp\/v2\/comments?post=89258"}],"version-history":[{"count":1,"href":"https:\/\/kellumphysicianpartners.com\/wp-json\/wp\/v2\/posts\/89258\/revisions"}],"predecessor-version":[{"id":89259,"href":"https:\/\/kellumphysicianpartners.com\/wp-json\/wp\/v2\/posts\/89258\/revisions\/89259"}],"wp:attachment":[{"href":"https:\/\/kellumphysicianpartners.com\/wp-json\/wp\/v2\/media?parent=89258"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/kellumphysicianpartners.com\/wp-json\/wp\/v2\/categories?post=89258"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/kellumphysicianpartners.com\/wp-json\/wp\/v2\/tags?post=89258"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
