Esophageal shortening during the era of laparoscopic surgery

Ziad T. Awad, Sumeet K. Mittal, Terese A. Roth, Peter I. Anderson, William A. Wilfley, Charles Filipi

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

An effective method for determining the presence of a short esophagus preoperatively would be helpful to surgeons. In this study 260 patients underwent primary laparoscopic antireflux surgery; 44 of them were suspected to have esophageal shortening on the basis of: (1) Barrett's esophagus or evidence of peptic stricture formation on endoscopy; (2) an irreducible hiatal hernia ≥ 5 cm in length on upright barium esophagram; or (3) a short esophagus on manometric analysis, defined as 2 SD below normal for height. Six patients without preoperative criteria required extensive esophageal mobilization and intraoperative endoscopic/laparoscopic assessment. Preoperative results were then compared with intraoperative esophageal length assessments. Altogether, 13 patients (5% of the whole series) underwent a lengthening procedure: left thoracoscopically assisted laparoscopic Collis gastroplasty (n = 11) or open transthoracic Collis gastroplasty (n = 2) plus antireflux repair (Nissen fundoplication in 9 and Toupet repair in 4). Among the preoperative tests, endoscopy had the highest sensitivity rate (61%); a combination of tests resulted in an increase in the specificity (63-100%) without a corresponding increase in sensitivity (28-42%). Preoperative testing is thus useful for predicting the need for an esophageal lengthening procedure. Endoscopy is the best screening test for the short esophagus. A well planned prospective trial to test the reliability of each test is needed.

Original languageEnglish
Pages (from-to)558-561
Number of pages4
JournalWorld Journal of Surgery
Volume25
Issue number5
DOIs
StatePublished - May 2001

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Laparoscopy
Gastroplasty
Esophagus
Endoscopy
Fundoplication
Hiatal Hernia
Barrett Esophagus
Barium
Digestion
Pathologic Constriction
Surgeons

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Awad, Z. T., Mittal, S. K., Roth, T. A., Anderson, P. I., Wilfley, W. A., & Filipi, C. (2001). Esophageal shortening during the era of laparoscopic surgery. World Journal of Surgery, 25(5), 558-561. https://doi.org/10.1007/s002680020075

Esophageal shortening during the era of laparoscopic surgery. / Awad, Ziad T.; Mittal, Sumeet K.; Roth, Terese A.; Anderson, Peter I.; Wilfley, William A.; Filipi, Charles.

In: World Journal of Surgery, Vol. 25, No. 5, 05.2001, p. 558-561.

Research output: Contribution to journalArticle

Awad, ZT, Mittal, SK, Roth, TA, Anderson, PI, Wilfley, WA & Filipi, C 2001, 'Esophageal shortening during the era of laparoscopic surgery', World Journal of Surgery, vol. 25, no. 5, pp. 558-561. https://doi.org/10.1007/s002680020075
Awad, Ziad T. ; Mittal, Sumeet K. ; Roth, Terese A. ; Anderson, Peter I. ; Wilfley, William A. ; Filipi, Charles. / Esophageal shortening during the era of laparoscopic surgery. In: World Journal of Surgery. 2001 ; Vol. 25, No. 5. pp. 558-561.
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