医学
格尔德
吞咽困难
胃-
质子抑制剂泵
回流
胃排空
外科
肌切开术
气胀
疾病
胃
食管
胃肠病学
内科学
贲门失弛缓症
作者
Pier Alberto Testoni,Giorgia Mazzoleni,Sabrina Gloria Giulia Testoni
出处
期刊:World Journal of Gastrointestinal Pharmacology and Therapeutics
[Baishideng Publishing Group Co]
日期:2016-01-01
卷期号:7 (2): 179-179
被引量:42
标识
DOI:10.4292/wjgpt.v7.i2.179
摘要
Gastro-esophageal reflux disease (GERD) is a very common disorder that results primarily from the loss of an effective antireflux barrier, which forms a mechanical obstacle to the retrograde movement of gastric content. GERD can be currently treated by medical therapy, surgical or endoscopic transoral intervention. Medical therapy is the most common approach, though concerns have been increasingly raised in recent years about the potential side effects of continuous long-term medication, drug intolerance or unresponsiveness, and the need for high dosages for long periods to treat symptoms or prevent recurrences. Surgery too may in some cases have consequences such as long-lasting dysphagia, flatulence, inability to belch or vomit, diarrhea, or functional dyspepsia related to delayed gastric emptying. In the last few years, transoral incisionless fundoplication (TIF) has proved an effective and promising therapeutic option as an alternative to medical and surgical therapy. This review describes the steps of the TIF technique, using the EsophyX(®) device and the MUSE(TM) system. Complications and their management are described in detail, and the recent literature regarding the outcomes is reviewed. TIF reconfigures the tissue to obtain a full-thickness gastro-esophageal valve from inside the stomach, by serosa-to-serosa plications which include the muscle layers. To date the procedure has achieved lasting improvement of GERD symptoms (up to six years), cessation or reduction of proton pump inhibitor medication in about 75% of patients, and improvement of functional findings, measured by either pH or impedance monitoring.
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