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Laparoscopic antireflux surgery for gastroesophageal reflux disease after lung transplantation. J Surg Res 2011 Oct;170(2):e279-86

Date

08/06/2011

Pubmed ID

21816422

Pubmed Central ID

PMC3686158

DOI

10.1016/j.jss.2011.05.038

Scopus ID

2-s2.0-80052790023   27 Citations

Abstract

BACKGROUND: Although gastroesophageal reflux disease (GERD) is highly prevalent in lung transplantation, the pathophysiology of GERD in these patients is unknown. We hypothesize that the pathophysiology of GERD after lung transplantation differs from that of a control population, and that the 30-d morbidity and mortality of laparoscopic antireflux surgery (LARS) are equivalent in both populations.

METHODS: We retrospectively compared the pathophysiology of GERD and the 30-d morbidity and mortality of 29 consecutive lung transplant patients with 23 consecutive patients without lung transplantation (control group), all of whom had LARS for GERD between November 2008 and May 2010.

RESULTS: Both groups had a similar prevalence of endoscopic esophagitis and Barrett's esophagus , comparable manometric profiles, and similar prevalence of abnormal peristalsis. However, hiatal hernia was more common in controls than in lung transplant patients (57% versus 24%; P = 0.04). Lung transplant patients had a higher prevalence and severity of proximal GERD (65% versus 33%; P = 0.04). The 30-d morbidity and mortality following LARS were similar in both groups regardless of the higher surgical risk of lung transplants (median ASA class: 3 versus 2 for controls, P < 0.001).

CONCLUSIONS: These results show that despite similar manometric profiles, lung transplant patients are more prone to proximal reflux than the general population with GERD; the prevalence of endoscopic esophagitis and Barrett's esophagus is the same in both groups of patients; a hiatal hernia is uncommon after lung transplantation; and the morbidity and mortality of LARS are the same for lung transplant patients as the general population with GERD.

Author List

Fisichella PM, Davis CS, Gagermeier J, Dilling D, Alex CG, Dorfmeister JA, Kovacs EJ, Love RB, Gamelli RL

Author

Christopher Stephen Davis MD, MPH Assistant Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Barrett Esophagus
Esophagitis
Esophagus
Female
Gastroesophageal Reflux
Hernia, Hiatal
Humans
Hydrogen-Ion Concentration
Laparoscopy
Lung Diseases
Lung Transplantation
Male
Manometry
Middle Aged
Morbidity
Postoperative Complications
Prevalence
Retrospective Studies
Risk Factors
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a