Foreshortened Oesophagus and Its Surgical Therapy (GERDSurgery)

The existence, diagnosis and treatment of short oesophagus is one of the controversies of the past which has recently re-emerged. The missed diagnosis of short oesophagus and the consequent inadequacy of treatment is one of the major causes of failure of antireflux surgery.

Official Title

Frequency, Predictors, Intraoperative Assessment and Outcome of Foreshortened Esophagus and Its Surgical Therapy in Patients Treated for Gastro-Esophageal Reflux Disease (GERD).

Conditions

• Gastroesophageal Reflux Disease
• Hiatal Hernia

Study Type

Observational

Study Design

Natural History, Longitudinal, Defined Population, Prospective Study.

 

  

Further Details

The daily clinical practice of surgeons dedicated to therapy of oesophageal diseases could take advantage of the definition of frequency, preoperative predictors, intraoperative management and post operative outcomes of cases of foreshortened oesophagus, in order to offer the patient affected by GERD the elements necessary for a conscious choice of therapy and to plan the best performance of the surgical procedure.

Aims of the Study

To define the percentage of cases among the total of antireflux procedures performed, in which, after standard isolation of the ge junction and eventual dissection of the mediastinal oesophagus at least two centimetres of oesophagus can not be replaced without any applied tension below the apex of the diaphragmatic hiatus.

To define the percentage of surgical procedures aimed to treat electively a condition of non reducible G-E junction and foreshortened oesophagus, among a multicentric formed case series of patients submitted to antireflux surgery.

To define the preoperative clinical and instrumental predictors for a surgical procedure aimed to treat foreshortened oesophagus.

To record the intra-operative, postoperative, 6 month and 12 month outcome of procedures adopted for the surgical treatment of GERD.

Materials and Methods

The study will comprise patients in which surgical therapy for GERD is indicated according to the international guidelines and the Centres policy.

Patients will be submitted to the antireflux procedure chosen by the surgeon according to the internationally recognised scientific surgical principles and the personal judgement.

The preoperative study and the postoperative follow up adopted in the present study are accepted by the Centres as they correspond to the international guidelines and the Centres’ current practice criteria for the surgical treatment of GERD.

Study Start

September 2005

Eligibility & Criteria

• Ages Eligible for Study: 18 years and older
• Genders Eligible for Study: Both
• Accepts Healthy Volunteers: No

Inclusion Criteria:

• patients aged > 18 years, undergoing surgery for the treatment of GORD, of massive incarcerated hiatus hernia GORD, in which a laparotomic, laparoscopic or thoracotomic approach is preoperatively indicated.

Exclusion Criteria:

• Association of GERD with epiphrenic oesophageal diverticulum, collagen diseases, undetermined oesophageal motility disorders;
• Redo antireflux surgery, previous surgery on the thoracic and abdominal oesophagus and stomach, on the diaphragm.  

   

Total Enrolment

180

Contact Details

Italian Department of Surgery, Intensive Care and Organ Transplantation
Bologna
Italy, 40138