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Video-Laparoscopic Treatment of Intrathoracic Gastric Volvulus

BACKGROUND: Gastric volvulus is a rare condition, characterized by abnormal rotation of the stomach, causing obstruction with risk of ischemia, necrosis, and perforation. It is associated with high morbidity and mortality rates and, as it is life threatening, early diagnosis and treatment are crucia...

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Autores principales: Lopes, Luiz Roberto, Chaim, Fabio Henrique Mendonça, Santos, Isabella Gusson Galdino, Coelho Neto, João de Souza, Tercioti, Valdir, Antonio Possato Ferrer, José, Andreollo, Nelson Adami
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791092/
https://www.ncbi.nlm.nih.gov/pubmed/33447006
http://dx.doi.org/10.4293/JSLS.2020.00061
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author Lopes, Luiz Roberto
Chaim, Fabio Henrique Mendonça
Santos, Isabella Gusson Galdino
Coelho Neto, João de Souza
Tercioti, Valdir
Antonio Possato Ferrer, José
Andreollo, Nelson Adami
author_facet Lopes, Luiz Roberto
Chaim, Fabio Henrique Mendonça
Santos, Isabella Gusson Galdino
Coelho Neto, João de Souza
Tercioti, Valdir
Antonio Possato Ferrer, José
Andreollo, Nelson Adami
author_sort Lopes, Luiz Roberto
collection PubMed
description BACKGROUND: Gastric volvulus is a rare condition, characterized by abnormal rotation of the stomach, causing obstruction with risk of ischemia, necrosis, and perforation. It is associated with high morbidity and mortality rates and, as it is life threatening, early diagnosis and treatment are crucial. METHODS: Retrospective study of medical records of intrathoracic gastric volvulus patients treated by video-laparoscopy from January 2000 to December 2018, in a University Hospital. RESULTS: Thirty patients (34 surgical procedures – 4 re-operations), 9 (30%) male and 21 (70%) female. The mean age was 57.65 ± 32.65 and the mean body mass index was 27.11 ± 3.5 kg/m(2). The most prevalent symptoms were epigastric pain and dysphagia. In 41.17% of the cases, the contrast X-ray confirmed the diagnosis. All 34 cases were intrathoracic volvulus, 24 of which were organo-axial (70.58%). The surgical technique used was hiatoplasty, without mesh (25 cases; 73.52%) and with reinforcement mesh (9 cases; 26.47%), mostly associated with Nissen fundoplication (52.94%). The mean surgical time was 215.7 ± 62.9 minutes, with conversion in 5 cases (15.62%). Hospitalization ranged from 4 ± 2 days. There was no record of operative mortality, and symptom improvement occurred in 100% of patients. The mean follow-up time for patients was 41.8 ± 32.6 months. CONCLUSIONS: Surgical treatment should be indicated to reduce morbidity and mortality, and associated with improved symptoms and patient prognosis. Video-laparoscopic surgery on intrathoracic gastric volvulus proved to be safe and effective and should be the option of choice in the management of this disease.
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spelling pubmed-77910922021-01-13 Video-Laparoscopic Treatment of Intrathoracic Gastric Volvulus Lopes, Luiz Roberto Chaim, Fabio Henrique Mendonça Santos, Isabella Gusson Galdino Coelho Neto, João de Souza Tercioti, Valdir Antonio Possato Ferrer, José Andreollo, Nelson Adami JSLS Research Article BACKGROUND: Gastric volvulus is a rare condition, characterized by abnormal rotation of the stomach, causing obstruction with risk of ischemia, necrosis, and perforation. It is associated with high morbidity and mortality rates and, as it is life threatening, early diagnosis and treatment are crucial. METHODS: Retrospective study of medical records of intrathoracic gastric volvulus patients treated by video-laparoscopy from January 2000 to December 2018, in a University Hospital. RESULTS: Thirty patients (34 surgical procedures – 4 re-operations), 9 (30%) male and 21 (70%) female. The mean age was 57.65 ± 32.65 and the mean body mass index was 27.11 ± 3.5 kg/m(2). The most prevalent symptoms were epigastric pain and dysphagia. In 41.17% of the cases, the contrast X-ray confirmed the diagnosis. All 34 cases were intrathoracic volvulus, 24 of which were organo-axial (70.58%). The surgical technique used was hiatoplasty, without mesh (25 cases; 73.52%) and with reinforcement mesh (9 cases; 26.47%), mostly associated with Nissen fundoplication (52.94%). The mean surgical time was 215.7 ± 62.9 minutes, with conversion in 5 cases (15.62%). Hospitalization ranged from 4 ± 2 days. There was no record of operative mortality, and symptom improvement occurred in 100% of patients. The mean follow-up time for patients was 41.8 ± 32.6 months. CONCLUSIONS: Surgical treatment should be indicated to reduce morbidity and mortality, and associated with improved symptoms and patient prognosis. Video-laparoscopic surgery on intrathoracic gastric volvulus proved to be safe and effective and should be the option of choice in the management of this disease. Society of Laparoendoscopic Surgeons 2020 /pmc/articles/PMC7791092/ /pubmed/33447006 http://dx.doi.org/10.4293/JSLS.2020.00061 Text en © 2020 by JSLS, Journal of the Society of Laparoscopic & Robotic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Research Article
Lopes, Luiz Roberto
Chaim, Fabio Henrique Mendonça
Santos, Isabella Gusson Galdino
Coelho Neto, João de Souza
Tercioti, Valdir
Antonio Possato Ferrer, José
Andreollo, Nelson Adami
Video-Laparoscopic Treatment of Intrathoracic Gastric Volvulus
title Video-Laparoscopic Treatment of Intrathoracic Gastric Volvulus
title_full Video-Laparoscopic Treatment of Intrathoracic Gastric Volvulus
title_fullStr Video-Laparoscopic Treatment of Intrathoracic Gastric Volvulus
title_full_unstemmed Video-Laparoscopic Treatment of Intrathoracic Gastric Volvulus
title_short Video-Laparoscopic Treatment of Intrathoracic Gastric Volvulus
title_sort video-laparoscopic treatment of intrathoracic gastric volvulus
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791092/
https://www.ncbi.nlm.nih.gov/pubmed/33447006
http://dx.doi.org/10.4293/JSLS.2020.00061
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