Predictive factors for short gastric vessels division during laparoscopic total fundoplication

Revista do Colégio Brasileiro de Cirurgiões

Alexandre Chartuni Pereira Teixeira¹  Fernando Augusto Mardiros Herbella¹  Adorísio Bonadiman¹  José Francisco De Mattos Farah¹  José Carlos Del Grande¹ 

关键词: Fundoplication;    Video-Assisted Surgery;    Gastroesophageal Reflux;    Gastric Fundus;    Fundoplicatura;    Cirurgia Vídeoassistida;    Refluxo Gastroesofágico;    Fundo Gástrico;   

DOI  :  10.1590/0100-69912015003005

来源: SciELO

【 摘 要 】

to determine clinical variables that can predict the need for division of the short gastric vessels (SGV), based on the gastric fundus tension, assessing postoperative outcomes in patients submitted or not to section of these vessels. we analyzed data from 399 consecutive patients undergoing laparoscopic fundoplication for gastroesophageal reflux disease (GERD). The section of the SGV was performed according to the surgeon evaluation, based on the fundus tension. Patients were divided into two groups: not requiring SGV section (group A) or requiring SGV section (group B). the section was not necessary in 364 (91%) patients (Group A) and required in 35 (9%) patients (Group B). Group B had proportionally more male patients and higher average height. The endoscopic parameters were worse for Group B, with larger hiatal hernias, greater hernias proportion with more than four centimeters, more intense esophagitis, higher proportion of Barrett's esophagus and long Barrett's esophagus. Male gender and grade IV-V esophagitis were considered independent predictors in the multivariate analysis. Transient dysphagia and GERD symptoms were more common in Group B. the division of the short gastric vessels is not required routinely, but male gender and grade IV-V esophagitis are independent predictors of the need for section of these vessels.

【 授权许可】

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