A combined laparoscopic-endoscopic method of assessment to prevent the complications of short esophagus |
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Authors: | Z T Awad T J Dickason C J Filipi Y Shiino R E Marsh T Tomonaga M R Tasset S Mittal |
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Institution: | (1) Department of Surgery, Suite 3740, Creighton University School of Medicine, 601 North 30th Street, Omaha, NE 68131, USA, US |
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Abstract: | As antireflux surgery has been used increasingly for gastroesophageal reflux disease (GERD), a need has arisen for an accurate
method to assess esophageal length. There are a number of preoperative tests that can help surgeons to establish the presence
of a short esophagus, but intraoperative assessment after esophageal mobilization is the standard method. In this era of laparoscopic
surgery, the surgeon mobilizes the esophagus extensively from the abdomen and then determines if mobilization is sufficient.
We report an intraoperative technique that combines laparoscopic with endoscopic methods to determine the position of the
gastroesophageal junction. Because two physicians are required, there is additional operating room time, resulting in increased
costs. However, these costs are offset by the assurance that the complications of the short esophagus can be avoided. With
experience, modifications were made, resulting in the technique described herein.
Received: 15 September 1998/Accepted: 15 January 1999 |
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Keywords: | : Gastroesophageal reflux disease — Esophagus — Short esophagus — Peptic stricture |
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