Esófago de Barrett y funduplicatura parcial posterior a 270° (Toupet)

2012 
The study included a thorough analysis and revision of 309 patients who were operated after being diagnosed with GERD. In 29 cases, (9.38% of patients) we diagnosed endoscopic and histopathologic Barrett esophagus (intestinal columnar metaplasia). All these patients underwent 270° posterior partial fundoplication Toupet type. The results were as following: All patients (100%) were subject of an endoscopy where 4 biopsies were taken. These biopsies were evidence of the Barrett esophagus diagnostic; 79% of these patients, however, had already had up to two endoscopies prior to the surgery, which had confi rmed the diagnostic as well. An evolution and diagnostic analysis was performed using a Visick scale. The analysis included: 21 male patients (72.5% of male patient population) and eight female patients (27.5% of the total female patient population). Of the male patients, 76% presented a hiatal hernia, 100% presented short EB, 9.5% presented motility disorder, 19.4% presented pirosis, 9.5% presented regurgitation and 9.5% presented both laryngitis and dry cough. Within the female patients, 62% presented a hiatal hernia, 87.5% presented short EB, 12.5% presented long EB, 12.5% presented motility disorder, 37.5% pirosis and 25% presented dry cough. All of these symptoms were prior to the surgery. The satisfaction ranking of the patients after the procedure was as follows: 90.5% of male and 100% of female patients ranked the procedure as good or excellent, while 9.5% of male patients ranked the procedure as moderate. From a histopathologic point of view, there is no knowledge of any data showing EB progression in any of the patients with short EB. The long EB diagnosed on the one female patient was also shortened. Two patients showed regression of the condition. Only 28% of the male and 12.5% of the female patients have occasionally required treatment after the procedure and this treatment has lasted no longer than 10 days.
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