Surgical Treatment of Gastroesophageal Reflux Disease and Hiatus Esophageal Hernias
Tratamiento Quirúrgico de la Enfermedad por Reflujo Gastro Esofágico y de las Hernias del Hiato Esofágico
Resumen:
Gastroesophageal reflux disease (GERD) is a chronic and recurrent condition that is linked to the retrograde passage of gastric contents, with or without duodenal contents, towards the esophagus and adjacent organs, with or without tissue damage (1).It is characterized by its chronicity and recurrence, as well as by being a benign pathology, but which adversely affects the quality of life of patients (2, 3, 4). The clinical presentation is highly variable, with typical symptoms being heartburn and regurgitation. Respiratory, otorhinolaryngological and chest pain are recognized as atypical symptoms betweenothers. In its evolution, it can develop complications such as esophagitis of variable degree with ulcerationand stricture, Barret's esophagus, and adenocarcinoma of the esophagus. GERD is a common disease, but with different prevalences in different countries. According to the international study DIGEST (Domestic / International Gastroentero-logy Surveillance Study) 7, 7% of the population refers symptoms of gastroesophageal reflux (5). Approximately 20% of North American adults have gastroesophageal reflux symptoms such as heartburn and acid regurgitations at least once a week (6, 7). In Uruguay, the estimated prevalence in the urban population was 4, 69, while for the populationhospital was 11.66%, using the GERD (Gastro-esophageal reflux disease Questionnaire) (8) The treatment of gastroesophageal reflux disease has undergone significant changes in the last two decades, motivated by a better study and knowledge of its aspects pathophysiological, in the use of proton pump inhibitors and in the development of laparoscopic surgery since the 1990s.
La enfermedad por reflujo gastroesofágico (ERGE) es una condición crónica y recurrente que se vincula al pasaje retrogrado del contenido gástrico, con o sin contenido duodenal, hacia el esófago y órganos adyacentes, con o sin lesión tisular (1).Se caracteriza por su cronicidad y recurrencia, así como por ser una patología benigna, pero que afecta desfavorablemente la calidad de vida de los pacientes (2, 3, 4). La presentación clínica es muy variable, siendo sus síntomas típicos la pirosis y las regurgitaciones. Se reconocen como síntomas atípicos los respiratorios, otorrinolaringológicos y el dolor torácico entreotros. En su evolución puede desarrollar complicaciones como una esofagitis de grado variable con ulceracióny estenosis, esófago de Barret y adenocarcinoma de esófago. La ERGE es una enfermedad frecuente, pero con prevalencias distintas en diferentes países. De acuerdo al estudio internacional DIGEST (Domestic/International Gastroentero-logy SurveillanceStudy) un 7, 7% de la población refiere síntomas de reflujo gastroesofágico (5). Aproximadamente un 20% de los adultos norteamericanos tienen síntomas de reflujo gastroesofágico como pirosis y regurgitaciones ácidas por lo menos una vez a la semana (6, 7) En Uruguay la prevalencia estimada en la población urbana fue de 4, 69, mientras que para la poblaciónhospitalaria fue de 11, 66%, utilizando el GERD (Gastro-esophageal reflux disease Questionnaire) (8) El tratamiento de la enfermedad por reflujo gastroesofágico ha tenido cambios significativos en las últimas dos décadas, motivados en un mejor estudio y conocimiento de sus aspectos fisiopatológicos, en la utilización de los inhibidores de la bomba de protones y en el desarrollo desde la década del 90 de la cirugía laparoscópica.
2013 | |
reflujo gastroesofágico tratamiento quirúrgico cirugía antireflujo cirugía laparosc´opica hernia hiatal casos clínicos complicaciones operatorias |
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Español | |
Sociedad de Cirugía del Uruguay | |
Relatos de los Congresos Uruguayos de Cirugía | |
https://revista.scu.org.uy/index.php/relatos/article/view/4831 | |
Acceso abierto |
Sumario: | Gastroesophageal reflux disease (GERD) is a chronic and recurrent condition that is linked to the retrograde passage of gastric contents, with or without duodenal contents, towards the esophagus and adjacent organs, with or without tissue damage (1).It is characterized by its chronicity and recurrence, as well as by being a benign pathology, but which adversely affects the quality of life of patients (2, 3, 4). The clinical presentation is highly variable, with typical symptoms being heartburn and regurgitation. Respiratory, otorhinolaryngological and chest pain are recognized as atypical symptoms betweenothers. In its evolution, it can develop complications such as esophagitis of variable degree with ulcerationand stricture, Barret's esophagus, and adenocarcinoma of the esophagus. GERD is a common disease, but with different prevalences in different countries. According to the international study DIGEST (Domestic / International Gastroentero-logy Surveillance Study) 7, 7% of the population refers symptoms of gastroesophageal reflux (5). Approximately 20% of North American adults have gastroesophageal reflux symptoms such as heartburn and acid regurgitations at least once a week (6, 7). In Uruguay, the estimated prevalence in the urban population was 4, 69, while for the populationhospital was 11.66%, using the GERD (Gastro-esophageal reflux disease Questionnaire) (8) The treatment of gastroesophageal reflux disease has undergone significant changes in the last two decades, motivated by a better study and knowledge of its aspects pathophysiological, in the use of proton pump inhibitors and in the development of laparoscopic surgery since the 1990s. |
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