María del Carmen García Gavilán, Víctor Manuel Aguilar Urbano, Estela Soria López
Introducción: el diagnóstico del ERGE es clínico y por pruebas complementarias (PPCC). La funduplicatura se propone como tratamiento definitivo, aunque un 15% persisten sintomáticos. Es importante descartar patología subyacente previamente a la cirugía.
Objetivos: evaluar el estudio pre y postquirúrgico, y los resultados a medio plazo de la funduplicatura por ERGE. Analizar la influencia de la sintomatología asociada con los resultados de las PPCC.
Material y métodos: estudio descriptivo-retrospectivo de pacientes con funduplicatura de Nissen por ERGE entre 2004-2014 en la Agencia Sanitaria Costa del Sol. Se analiza la sintomatología asociada, PPCC pre y postquirúrgicas, indicaciones de cirugía, resultados y tiempo de seguimiento. Analizar la relación entre los síntomas asociados y los hallazgos en las PPCC, así como entre la toma de IBP postquirúrgica y necesidad de reintervención.
Resultados: 185 pacientes incluidos, 57,7% varones. 39,5% presentaron síntomas asociados (23,2% dispepsia). El 100% se estudia con PPCC prequirúrgicas, 98,4% gastroscopia. No observamos relación entre la sintomatología asociada y las alteraciones en las PPCC prequirúrgicas. Tras la funduplicatura 44,9% persisten sintomáticos (16,8% por pirosis). El 73,5% se estudia con alguna PPCC en una media de seguimiento de 11,45 meses. El 29,2% tomaba IBP tras la cirugía, aunque no se observó relación con alteraciones en la pHmetría, sí con la necesidad de reintervención (p0,003).
Conclusión: En nuestro medio el 23,2% del ERGE se asocia a síntomas dispépticos. El 100% se estudia con PPCC prequirúrgicas. La funduplicatura es resolutiva en el 55,1%, aunque el uso de IBP postquirúrgico continúa siendo alto y frecuentemente inadecuado.
Introduction: GERD is diagnosed after clinical diagnosis and complementary tests (CTs). Fundoplication is proposed as a definitive treatment, although 15% of patients remain symptomatic. It is important to rule out underlying pathologies prior to surgery.
Objectives: Evaluation of preoperative and postoperative studies, and medium term results of fundoplication for GERD. Analysis of the influence of the symptomatology associated with the results of the CTs.
Material and methods: Descriptive-retrospective study of patients with Nissen fundoplication for GERD between 2004-2014 at the Costa del Sol Health Agency. Associated symptoms, preoperative and postoperative CTs, surgery indications, results and follow-up time were analyzed. Analysis of the relationship between the associated symptoms and the findings in the CTs, as well as the relationship between post-operative PPI and the need for undergoing surgery again.
Results: The study included 185 patients, 57,7% of them male. 39,5% presented associated symptoms (23,2% dyspepsia). 100% were studied with presurgical CTs, and 98,4% with gastroscopy. We did not observe any kind of relationship between the associated symptomatology and the alterations in the preoperative CTs. After fundoplication 44,9% of patients remained symptomatic (16,8% for heartburn). 73,5% of the patients undergoes studies with some kind of CTs in a mean follow-up of 11,45 months. 29,2% of patients were administered PPI after surgery, although no relationship was observed with alterations in pHmetry, although they were observed with the need for undergoing surgery again (p0,003).
Conclusions: In our study, 23,2% of patients with GERD showed associated dyspeptic symptoms. 100% were studied with presurgical CTs. Fundoplication was resolutive in 55,1% of cases, although the use of postoperative IBP remains high and frequently inadequate.
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