BACKGROUND Laparoscopic Heller cardiomyotomy (LHC) is standard therapy for achalasia. Traditionally, an antireflux procedure has accompanied the myotomy. This study was undertaken to compare quality-of-life outcomes between patients undergoing myotomy with Toupet versus Dor fundoplication. In addition, we investigated overall patient satisfaction after LHC in the treatment of achalasia. METHO...

Esophagogastric fistula is a rare complication following Nissen fundoplication, with symptoms usually developing within weeks to 3 years postoperatively.1-3 Proposed mechanisms include recalcitrant reflux, erosion of sutures with Teflon pledgets, and damage associated with repeat procedures.1-3 Past reports describe management of the esophagogastric fistulae with antireflux medications, dilatio...

The basic principle of antireflux procedures employing endoscopic intervention aims to create a mechanical barrier to prevent primary pathophysiology in gastroesophageal reflux disease (GERD). We review, highlight, and discuss the past and present status of endoluminal therapy. Currently, there are 3 commonly employed anti-reflux endoluminal procedures: fundoplication or suturing techniques (En...

OBJECTIVES/HYPOTHESIS Although the diagnostic accuracy of paradoxical vocal fold movement disorder and chronic cough has improved, the underlying pathophysiology remains relatively unknown. We hypothesize that one potential etiological factor in these patients is an aberrant laryngeal sensory response and sought to determine if respiratory retraining in addition to antireflux therapy alters thi...

HYPOTHESIS To determine if a hypercontractile esophagus, manifested by high-amplitude peristaltic contractions (HAPCs) or hypertensive lower esophageal sphincter (HLES), affects the outcome of antireflux surgery. DESIGN Case series. Prospectively maintained database. Direct contact with patients. Mean follow-up 28.7 months. SETTING University hospital. PATIENTS Of 643 patients who had ant...

The review raised current problems arising from the use of various surgical methods for treatment gastroesophageal reflux disease and small diaphragmatic hernias. literature search aimed to identify main indications, criteria choosing laparoscopic antireflux surgeries, compare results on frequency relapses complications posterior cruroraphia Nissen fundoplication. Various techniques fundoplicat...

HYPOTHESIS Laparoscopic techniques can be used to treat patients whose antireflux surgery has failed. DESIGN Case series. SETTING Two academic medical centers. PATIENTS Forty-six consecutive patients, of whom 21 were male and 25 were female (mean age, 55.6 years; range, 15-80 years). Previous antireflux procedures were laparoscopic (21 patients), laparotomy (21 patients), thoracotomy (3 p...