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ENDOSCOPIC EVALUATION OF POST-FUNDOPLICATION ANATOMY AND CORRELATION WITH SYMPTOMATOLOGY

BACKGROUND: Upper digestive endoscopy is important for the evaluation of patients submitted to fundoplication, especially to elucidate postoperative symptoms. However, endoscopic assessment of fundoplication anatomy and its complications is poorly standardized among endoscopists, which leads to inad...

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Autores principales: MARTINS, Bruno Costa, SOUZA, Clarissa Santos, RUAS, Jennifer Nakamura, FURUYA, Carlos Kiyoshi, FYLYK, Sonia Nadia, SAKAI, Christiano Makoto, IDE, Edson
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Colégio Brasileiro de Cirurgia Digestiva 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7812682/
https://www.ncbi.nlm.nih.gov/pubmed/33470373
http://dx.doi.org/10.1590/0102-672020200003e1543
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author MARTINS, Bruno Costa
SOUZA, Clarissa Santos
RUAS, Jennifer Nakamura
FURUYA, Carlos Kiyoshi
FYLYK, Sonia Nadia
SAKAI, Christiano Makoto
IDE, Edson
author_facet MARTINS, Bruno Costa
SOUZA, Clarissa Santos
RUAS, Jennifer Nakamura
FURUYA, Carlos Kiyoshi
FYLYK, Sonia Nadia
SAKAI, Christiano Makoto
IDE, Edson
author_sort MARTINS, Bruno Costa
collection PubMed
description BACKGROUND: Upper digestive endoscopy is important for the evaluation of patients submitted to fundoplication, especially to elucidate postoperative symptoms. However, endoscopic assessment of fundoplication anatomy and its complications is poorly standardized among endoscopists, which leads to inadequate agreement. AIM: To assess the frequency of postoperative abnormalities of fundoplication anatomy using a modified endoscopic classification and to correlate endoscopic findings with clinical symptoms. METHOD: This is a prospective observational study, conducted at a single center. Patients were submitted to a questionnaire for data collection. Endoscopic assessment of fundoplication was performed according to the classification in study, which considered four anatomical parameters including the gastroesophageal junction position in frontal view (above or at the level of the pressure zone); valve position at retroflex view (intra-abdominal or migrated); valve conformation (total, partial, disrupted or twisted) and paraesophageal hernia (present or absent). RESULTS: One hundred patients submitted to fundoplication were evaluated, 51% male (mean age: 55.6 years). Forty-three percent reported postoperative symptoms. Endoscopic abnormalities of fundoplication anatomy were reported in 46% of patients. Gastroesophageal junction above the pressure zone (slipped fundoplication), and migrated fundoplication, were significantly correlated with the occurrence of postoperative symptoms. There was no correlation between symptoms and conformation of the fundoplication (total, partial or twisted). CONCLUSION: This modified endoscopic classification proposal of fundoplication anatomy is reproducible and seems to correlate with symptomatology. The most frequent abnormalities observed were slipped and migrated fundoplication, and both correlated with the presence of symptoms.
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spelling pubmed-78126822021-01-22 ENDOSCOPIC EVALUATION OF POST-FUNDOPLICATION ANATOMY AND CORRELATION WITH SYMPTOMATOLOGY MARTINS, Bruno Costa SOUZA, Clarissa Santos RUAS, Jennifer Nakamura FURUYA, Carlos Kiyoshi FYLYK, Sonia Nadia SAKAI, Christiano Makoto IDE, Edson Arq Bras Cir Dig Original Article BACKGROUND: Upper digestive endoscopy is important for the evaluation of patients submitted to fundoplication, especially to elucidate postoperative symptoms. However, endoscopic assessment of fundoplication anatomy and its complications is poorly standardized among endoscopists, which leads to inadequate agreement. AIM: To assess the frequency of postoperative abnormalities of fundoplication anatomy using a modified endoscopic classification and to correlate endoscopic findings with clinical symptoms. METHOD: This is a prospective observational study, conducted at a single center. Patients were submitted to a questionnaire for data collection. Endoscopic assessment of fundoplication was performed according to the classification in study, which considered four anatomical parameters including the gastroesophageal junction position in frontal view (above or at the level of the pressure zone); valve position at retroflex view (intra-abdominal or migrated); valve conformation (total, partial, disrupted or twisted) and paraesophageal hernia (present or absent). RESULTS: One hundred patients submitted to fundoplication were evaluated, 51% male (mean age: 55.6 years). Forty-three percent reported postoperative symptoms. Endoscopic abnormalities of fundoplication anatomy were reported in 46% of patients. Gastroesophageal junction above the pressure zone (slipped fundoplication), and migrated fundoplication, were significantly correlated with the occurrence of postoperative symptoms. There was no correlation between symptoms and conformation of the fundoplication (total, partial or twisted). CONCLUSION: This modified endoscopic classification proposal of fundoplication anatomy is reproducible and seems to correlate with symptomatology. The most frequent abnormalities observed were slipped and migrated fundoplication, and both correlated with the presence of symptoms. Colégio Brasileiro de Cirurgia Digestiva 2021-01-15 /pmc/articles/PMC7812682/ /pubmed/33470373 http://dx.doi.org/10.1590/0102-672020200003e1543 Text en https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License
spellingShingle Original Article
MARTINS, Bruno Costa
SOUZA, Clarissa Santos
RUAS, Jennifer Nakamura
FURUYA, Carlos Kiyoshi
FYLYK, Sonia Nadia
SAKAI, Christiano Makoto
IDE, Edson
ENDOSCOPIC EVALUATION OF POST-FUNDOPLICATION ANATOMY AND CORRELATION WITH SYMPTOMATOLOGY
title ENDOSCOPIC EVALUATION OF POST-FUNDOPLICATION ANATOMY AND CORRELATION WITH SYMPTOMATOLOGY
title_full ENDOSCOPIC EVALUATION OF POST-FUNDOPLICATION ANATOMY AND CORRELATION WITH SYMPTOMATOLOGY
title_fullStr ENDOSCOPIC EVALUATION OF POST-FUNDOPLICATION ANATOMY AND CORRELATION WITH SYMPTOMATOLOGY
title_full_unstemmed ENDOSCOPIC EVALUATION OF POST-FUNDOPLICATION ANATOMY AND CORRELATION WITH SYMPTOMATOLOGY
title_short ENDOSCOPIC EVALUATION OF POST-FUNDOPLICATION ANATOMY AND CORRELATION WITH SYMPTOMATOLOGY
title_sort endoscopic evaluation of post-fundoplication anatomy and correlation with symptomatology
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7812682/
https://www.ncbi.nlm.nih.gov/pubmed/33470373
http://dx.doi.org/10.1590/0102-672020200003e1543
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