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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...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Colégio Brasileiro de Cirurgia Digestiva
2021
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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. |
format | Online Article Text |
id | pubmed-7812682 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Colégio Brasileiro de Cirurgia Digestiva |
record_format | MEDLINE/PubMed |
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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