By George Y. Wu
Textual content describes the entire surgical and laparoscopic methods now used for the gastrointestinal tract. contains transparent, halftone illustrations and discussions of anatomical and physiological adjustments. additionally deals suggestion at the scientific administration of the postsurgical sufferer. For physicians. DNLM: Digestive procedure Surgical Procedures--methods.
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Additional resources for An Internist's Illustrated Guide to Gastrointestinal Surgery (Clinical Gastroenterology)
Chapter 4 / Surgery for GERD 37 Fig. 4. Type I hiatal or sliding hiatal hernia: coronal section. INDICATIONS FOR SURGERY The majority of patients with heartburn can be managed through modification of lifestyle and through medical management. These should be optimized prior to consideration of surgery. Caffeine, tobacco, and alcohol all decrease the LES pressure and cause reflux. Large meals late at night often results in nocturnal reflux symptoms. Their elimination will often improve GERD. Obesity increases intrabdominal pressure.
The association between GERD and esophagitis was not established until the 1940s, and much controversy arose concerning the relationship between hiatal hernia and GERD. Initial attempts at simply reducing the hernia by closing the crura proved to have unacceptably high failure rates. The Allison repair, introduced in 1951, involved mobilization of the distal esophagus with placement of the gastroesophageal junction within the abdomen and repair of the crura. This operation had a high recurrence rate, and subsequently several attempts were made at both fixing the gastroesophageal junction within the abdomen and wrapping the gastric fundus around the distal esophagus (fundoplication) to create an antireflux valve (1).
Dig Dis Sci 1998;43:1973–1977. 4. Pasricha PJ, Ravich WJ, Hendrix TR, et al. Intrasphicteric botulinum toxin for the treatment of achalasia. N Engl J Med 1995;332:774–778. 5. Spiess AE, Kahrilas PJ. Treating achalasia: from whalebone to laparoscope. JAMA 1998;280:638–642. 6. Hunter JG, Richardson WS. Surgical management of achalasia. Surg Clin N Am 1997;77:993–1015. 7. Richter JE. Comparison and cost analysis of different treatment strategies in achalasia. Gastrointest Endosc Clin N Am 2001;11:359–370.
An Internist's Illustrated Guide to Gastrointestinal Surgery (Clinical Gastroenterology) by George Y. Wu