Experience of 10 years in routine trans operative endoscopy and calibration in fundoplication due to gastroesophageal reflux disease

Cesar Manuel Vargas Sahagun; Jorge Alejandro Ortiz De La Peña Rodríguez; Enrique Jean Silver; Martín Vega De Jesús; Antonio Giovanni Spaventa Ibarrola; Cuauhtémoc Morfin Vela; Tomás Benavides Zavala; Elsa Paulina Alonso Lopez

doi:10.18203/2320-6012.ijrms20221787

Authors

Cesar Manuel Vargas Sahagun Department of Endoscopic Surgery, American British Cowdray Medical Center, Mexico City, Mexico
Jorge Alejandro Ortiz De La Peña Rodríguez Department of Endoscopic Surgery, American British Cowdray Medical Center, Mexico City, Mexico
Enrique Jean Silver Department of Endoscopic Surgery, American British Cowdray Medical Center, Mexico City, Mexico
Martín Vega De Jesús Department of Endoscopic Surgery, American British Cowdray Medical Center, Mexico City, Mexico
Antonio Giovanni Spaventa Ibarrola Department of Endoscopic Surgery, American British Cowdray Medical Center, Mexico City, Mexico
Cuauhtémoc Morfin Vela Department of Endoscopic Surgery, American British Cowdray Medical Center, Mexico City, Mexico
Tomás Benavides Zavala Department of Endoscopic Surgery, American British Cowdray Medical Center, Mexico City, Mexico
Elsa Paulina Alonso Lopez Department of Gastrointestinal Surgery, UMAE Hospital de Especialidades CMN Siglo XXI, Mexican Institute of Social Security. Mexico City, Mexico

DOI:

https://doi.org/10.18203/2320-6012.ijrms20221787

Keywords:

Fundoplication, Gastroesophageal reflux, Intraoperative endoscopy, Endoscopy control

Abstract

Background: Endoscopy and intraoperative calibration in fundoplication for gastroesophageal reflux disease (GERD), confirm an adequate technique avoiding postoperative failure. Intraoperative changes and morbidity in routine use are unknown.

Methods: Retrospective study in a single center, data were taken primarily from electronic archive medical records. A total of 899 who underwent fundoplication surgery with endoscopy and/or routine intraoperative calibration due to GERD met the required criteria between 1 January 2010 and 31 December 2020. The primary objective was to identify the number of calibration and intraoperative endoscopy findings. Also, the morbidity associated with its routine use was analyzed.

Results: Over a 10-year study period, the most frequent calibration in the Nissen Fundoplication was 60Fr in 472 cases (61.4 %). The most used calibration in Toupet Fundoplication was 60Fr in 26 cases (21.1%). Endoscopy was performed in 786 patients (71.38%), of which; 3 patients (0.3%) required changes, secondary to fundoplication rotation in 2 patients (0.2%) and redundant gastric fundus in 1 patient (0.1%).

Conclusions: Routine intraoperative calibration and endoscopy achieved excellent results in 96.8% of fundoplication’s, ensuring adequate esophageal position and corroborating an adequate intraoperative technique; decreasing the rate of failures and immediate postoperative dysphagia.

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