Download Antireflux Surgery by Lee L. Swanstrom, Christy M. Dunst PDF

By Lee L. Swanstrom, Christy M. Dunst

This quantity presents a complete, cutting-edge evaluation of the main matters particular to the sector of antireflux surgical procedure. It offers unheard of educational aspect relating to functionality of antireflux surgical procedure from best esophageal surgeons all over the world. This quantity represents the single source of its type devoted in particular to the problems precise to antireflux surgical procedure. it's wealthy intimately and beneficial illustrations that show surgeons in right approach in addition to providing the reasoning in the back of numerous thoughts. Written through specialists within the box, Antireflux surgical procedure is of serious worth to working towards surgeons who practice gastrointestinal surgical procedure, clinical scholars, surgical citizens, and fellows.

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The role played by alkalinization of gastric contents with acid suppressive drugs in increasing the extent of intestinal metaplasia in the esophagus would therefore promote carcinogenesis in reflux (Fig. 3). The most common location of reflux-induced adenocarcinoma is in the distal part of the intestinal metaplasia within the columnar lined segment near the junction of intestinal epithelium and non-intestinalized cardiac mucosa [62]. In the 1950s, adenocarcinoma was rare because intestinal metaplasia was rare and when it was present it was limited to the most proximal region of long segments of columnar lined esophagus, commonly in the mid-esophagus [37, 38].

Initial studies with LINX suggest that patients with early reflux disease have a high rate of success in controlling symptoms as well as normalizing the 24-h pH test. It is likely that the success of fundoplication will be greater if the operation is done earlier in the course of the disease where sphincter damage is less. (d) Cessation of all reflux: While complete cessation of reflux with a totally flat line on a 24-h pH study is achieved in some patients after a fundoplication, this is not the stated objective for this surgery.

3). In a mapping study of ten esophagectomy cases in 2007, we showed that intestinal metaplasia extended from the top of the columnar lined segment all the way into the dilated distal esophagus [17]. This contrasts with the mapping data of Paull et al. [55] where patients with long segments of columnar lined esophagus either had no intestinal metaplasia or intestinal metaplasia limited to the proximal part of the segment. The distal 3–4 cm of the segment in Paull et al. consisted of cardiac and oxyntocardiac epithelia [55].

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