Impaired postoperative EGJ relaxation as a determinant of post laparoscopic fundoplication dysphagia: a study with high-resolution manometry before and after surgery.

Background: Laparoscopic fundoplication (FP) reduces gastroesophageal reflux (GER) efficiently. Dysphagia is its main complication, but no clear data have been published in literature to evaluate risk factors associated with it. The goal of this retrospective study was to identify factors associated with dysphagia occurring after FP for GER disease, with high-resolution manometry (HRM) performed before and after surgery.

Achalasia-like disorder after laparoscopic adjustable gastric banding: a reversible side effect?

Literature data concerning the effect of laparoscopic adjustable gastric banding (LAGB) on esophageal motility are conflicting. Achalasia-like disorder involving the absence of esophageal peristalsis and impaired esophago-gastric junction (EGJ) is probably under-estimated and can result in failure and band removal. The aim of our study was to focus on cases of achalasia-like disorder and study its evolution after band deflating or removal.

Laparoscopic gastric bypass for failure of adjustable gastric banding: a review of 85 cases.

Laparoscopic adjustable gastric banding (LAGB) is the first bariatric procedure in Europe and is becoming more and more popular in North America. However, the failure rate at 5 years can reach 50%. Although there is still no consensus on revisional surgery, the trend seems to be in favor of conversion to gastric bypass (GBP) with encouraging results.

Laparoscopic repair of large hiatal hernia without prosthetic reinforcement: late results and relevance of anterior gastropexy.

Background: Laparoscopic treatment of large hiatal hernias seems to be associated with a high recurrence rate that some authors suggest to bring down by performing prosthetic closure of the hiatus. However, prosthetic repair remains controversial owing to severe and still underestimated complications. The aims of this study were to assess the long-term functional and objective results of laparoscopic treatment without prosthetic patch, and to identify the risk factors of recurrence.

Post-operative pressure lability and cardiac baroreflex in normotensive patients as a function of age.

Background: Pressure lability may be linked to the loss of the cardiac baroreflex. The reduction of the sensitivity of the cardiac baroreflex has not been delineated in the post-operative period according to age in normotensive patients. This study addresses pressure lability and slope of the cardiac baroreflex as a function of age.

Results of laparoscopic Heller myotomy without anti-reflux procedure in achalasia. Monocentric prospective study of 106 cases.

Background: Heller myotomy (HM) combined with an anti-reflux procedure has been shown to be effective for the treatment of achalasia, as postoperative gastro-esophageal reflux (GER) is observed in about 10% of the cases. Laparoscopy has brought an undeniable benefit in providing excellent visualisation of the gastro-esophageal junction (GEJ) without lateral and posterior dissection. Respecting the anatomical fixation of the GEJ seems to permit the performing of HM without an anti-reflux procedure, the need for which is therefore debatable.

[Esophageal leiomyoma. Six cases of video-assisted enucleation].

Aim Of The Study: To report our experience with video-assisted enucleation of esophageal leiomyomas.

Method: Retrospective analysis of six (five men and a woman) patients who underwent video-assisted submucosal tumor enucleation (4 with thoracoscopy and 2 with laparoscopy).

Results: Only one patient had postoperative complications: a parietal hematoma at a trocar site and a fever with right pleural, resolved after pleural drainage.

Characterization of reflux events after fundoplication using combined impedance-pH recording.

Background: Laparoscopic fundoplication effectively controls symptoms of gastro-oesophageal reflux disease (GORD) and decreases acid reflux, but its impact on non-acid reflux is not known. The aim of the study was to characterize reflux events after fundoplication using oesophageal combined multichannel intraluminal impedance (MII)-pH monitoring, to demonstrate its efficacy on acid as well as non-acid reflux events.

Methods: Thirty-six patients in whom ambulatory MII-pH recording was performed after laparoscopic fundoplication were reviewed retrospectively.

[Multiple gastro-intestinal stromal tumors (GIST) in a patient with type I neurofibromatosis revealed by chronic bleeding: pre-operative radiological diagnosis].

Recent studies have pointed out a high incidence of GIST, usually multiple and of small intestinal location, in patients with type I neurofibromatosis. We here report an additional case, revealed by chronic gastro-intestinal bleeding and diagnosed at pre-operative imaging studies. A 56-year-old patient, with known type I neurofibromatosis, was referred to our department for the exploration of chronic gastro-intestinal bleeding during anti-aggregant therapy.

Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients.

Background: The reported experience with laparoscopic pancreatic resections (LPR) remains limited to case reports or small series of patients.

Methods: A retrospective multicenter study was conducted in 25 European surgical centers concerning their experience with LPR. Detailed questionnaires were used, focusing on patients, tumors, operative data, and late outcome.

[Adenocarcinomas of the stomach and distal esophagus. Incidence and phenotypic characteristics of EBV-associated cases in the Lyons area, France].

Aims: Our study aimed to evaluate the incidence of EBV-associated adenocarcinomas of the stomach and distal esophagus in Lyons area and to assess their phenotypic characteristics.

Methods: 85 cases of gastric adenocarcinomas and 40 cases of esophageal adenocarcinomas were screened for EBV by in situ hybridization (EBER-1 and -2) and immunohistochemistry (LMP1 and EBNA-1); all cases positive for EBER by in situ hybridization were studied by PCR for demonstration of EBV DNA. The clinical, histological and immunophenotypic features of EBV-associated adenocarcinomas were assessed.

[Laparoscopic pancreatic resections].

The feasibility of laparoscopic pancreatic resection has been demonstrated. However, the real clinical benefit for the patients remains questioned. The best indication for a laparoscopic approach appears to be the resection of benign or neuro-endocrine tumors without a need for pancreato-enteric reconstruction (i.

Cytokeratin expression in adenocarcinomas of the esophagogastric junction: a comparative study of adenocarcinomas of the distal esophagus and of the proximal stomach.

Adenocarcinomas of the esophagogastric junction form a heterogeneous group of tumors. We aimed to evaluate the value of the expression pattern of cytokeratins 7, 19, and 20 for their diagnosis and classification. A total of 85 cases of adenocarcinoma of the distal esophagus and 67 cases of adenocarcinoma of the proximal stomach, defined on strict topographical criteria, were investigated.

[Hepatobiliary cystic tumors. Clinical, radiological and histopathological study of 7 cases].

Objectives: Hepatobiliary cystic tumors are rare, but must be correctly diagnosed because of their potential malignancy. We report the clinical, radiological, pathological and evolutive characteristics of 7 cases of hepatobiliary cystic tumors.

Material And Methods: Complete clinical charts were available.

Cystic endocrine tumors of the pancreas: clinical, radiologic, and histopathologic features in 13 cases.

Cystic endocrine tumors of the pancreas are rare and raise difficult clinical problems. Our aims were to reevaluate the diagnostic and therapeutic strategy and to assess their histopathologic characteristics. Thirteen cystic endocrine tumors diagnosed in 10 patients were included.

Complete response of an HIV negative gastric Kaposi's sarcoma (KS) patient with peritoneal carcinomatosis by liposomal daunorubicin treatment.

We report the first case of an HIV negative patient with gastric Kaposi's sarcoma (KS) and peritoneal carcinomatosis in whom a complete response (CR) was obtained after liposomal daunorubicin administration. The patient presented with epigastric pain and hematemesis. Upper gastric endoscopy with multiple biopsies showed gastric involvement by KS.

[Pneumatosis cystoides intestinalis, treated with laparoscopic colectomy].

The authors report a case of pneumatosis cystoides intestinalis which, after failure of medical treatment, was treated by laparoscopic partial colectomy. Surgical treatment is a last resort and the laparoscopically-assisted approach seems to be a good indication in colectomy for pneumatosis cystoides intestinalis.

Laparoscopic fundoplication for gastroesophageal reflux: effects on esophageal motility.

Laparoscopic Nissen-Rossetti fundoplication is now recognized as a valid therapy for the treatment of gastroesophageal reflux disease. This retrospective study evaluates the effects of laparoscopic fundoplication on esophageal motility and correlates these effects to postsurgical symptoms. A total of 123 patients underwent laparoscopic fundoplication at our institution.

[Colonic diverticulosis and laparoscopy. Analysis of a series of 60 cases].

Aim: This is a retrospective analysis of a series of 60 cases diverticular disease.

Material And Method: From May 1991 to April 1999, 60 laparoscopic colorectal resections were performed for diverticulitis.

Results: Conversion to a classical procedure was necessary in 3 patients (5%).

Left ventricular loading modifications induced by pneumoperitoneum: a time course echocardiographic study.

Unlabelled: The intraperitoneal insufflation of carbon dioxide during laparoscopic procedures is associated with an increase in mean arterial pressure and systemic vascular resistance. To evaluate the time course of the circulatory changes related to intraabdominal pressure variation, we used transesophageal echocardiography in 10 patients anesthetized for laparoscopic cholecystectomy. Left ventricular dimensions, fractional area shortening (FAS), and left ventricular afterload assessed by the left ventricular end-systolic wall stress (LVESWS) were measured from echocardiographic data before insufflation, during pneumoperitoneum, and during exsufflation.