Problem of decreasing the complications rate of intestinal urine derivation is very relevant. One of the most important problem is the stricture of urointestinal anastomosis. The problem of the choice of antireflux or direct method of ureters implantanion is not solved. Results of forming of 186 renoureteral units (RUU) according to direct method and 70 RUU according to antireflux method were analyzed by the authors. Straight anastomosis was applied according to Wallace 1 and 2 technique, antireflux--according to Abol-Enein technique or by means of transverse duplicating. Age of the patients ranged from 16 to 76 years (56 years on average); men prevailed in groups. Terms of supervision ranged from 6 to 108 months (54.6 months on average). Strictures and failure of ureteroreservoir anastomosis using Wallace method were not revealed (0%), then using antireflux methods (transverse duplicating or extramural Abol-Enein tunnel) the frequency of complication amounted 2.8% on average. Strictures after antireflux mode in case of their early exposure were successfully corrected using endoscopic methods. In other cases open revision of anastomoses with their repeated apply was carried out. Reno-reservoir reflux was not observed in any cases after antireflux methods. Clinical manifestation of reflux was revealed at 2 RUU. Basing on the data renal radionuclide of image renal function didn't significantly change after direct or antireflux methods of ureters implantation. Wallace method is remarkable for its technical usability. This method ensures low level of complications after as incontinent and continent urine derivation.
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BMJ Open
December 2024
Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, China
Introduction: Endoscopic antireflux therapy has shown promising potential in the treatment for gastro-oesophageal reflux disease (GERD). However, there is currently no universally accepted standard for endoscopic surgery. Therefore, we introduced antireflux mucosal valvuloplasty (ARMV), an innovative endoscopic treatment for GERD.
View Article and Find Full Text PDFSurg Endosc
January 2025
Faculty of Medicine, Pediatric Surgery, Tanta University Hospital, Tanta, 31527, Egypt.
Background: Surgical fundoplication remains integral in managing gastroesophageal reflux disease (GERD) by addressing gastroesophageal valve incompetence. This study introduces a novel hybrid approach, the Eversion Cruroplasty and Collar Overwrap (ECCO) procedure, aiming to combine benefits of conventional partial wrapping and posteromedial cardiopexy, considering gastric fundus anatomical peculiarities as an anti-reflux barrier.
Methods: A retrospective analysis of pediatric patients presenting with refractory GERD from 2021 to 2023 was conducted.
Several reconstruction methods are used in proximal gastrectomy. Esophagogastrostomy is the simplest and most physiological. The challenge in esophagogastrostomy is preventing reflux esophagitis.
View Article and Find Full Text PDFIntroduction: Potassium-competitive acid blockers are effective against proton pump inhibitor-refractory gastroesophageal reflux disease; however, their long-term use is associated with economic disadvantages. Endoscopic procedures may reduce potassium-competitive acid blocker use. This study aimed to determine the optimal treatment strategy for patients with proton pump inhibitor-refractory gastroesophageal reflux disease from a cost-effectiveness perspective.
View Article and Find Full Text PDFAliment Pharmacol Ther
December 2024
Division of Gastroenterology and Hepatology, University of Kansas School of Medicine, and Kansas City VA Medical Center, Kansas City, Missouri, USA.
Background: Many patients diagnosed with gastro-oesophageal reflux disease (GERD) have persistent symptoms despite proton pump inhibitor (PPI) therapy.
Aims: The aim of this consensus is to provide evidence-based statements to guide clinicians caring for patients with refractory reflux-like symptoms (rRLS) or refractory GERD.
Methods: This consensus was developed by the International Working Group for the Classification of Oesophagitis.
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