Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019270 (hernia)
 15,856 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The recurrent symptoms in 60 patients who had undergone surgical management of hiatal hernia with reflux were analysed with the help of manometry. Despite reduction of the hernia in 43 patients, the primary and important defect of sphincter incompetence was the commonest residual abnormality. Oesophageal spasm associated with reflux or occurring as a primary condition was another cause of recurrent symptoms. The addition of vagotomy and pyloroplasty to the hiatal hernia repair procedure in several patients did not prevent reflux. The use of valvuloplasty techniques such as the Hill posterior gastropexy, the Belsey Mark IV operation or the Nissen fundoplication should be encouraged when the primary defect is incompetence of the lower oesophageal sphincter.
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PMID:Hiatal hernia--manometric and symptomatic assessment of failed surgical management in 60 patients. 88 22

Diffuse esophageal spasm (DES) is a rare disease, and its surgical management is controversial. There are seven major reported series totaling 148 patients and six operative variations depending on the extent of myotomy and whether or not a hernia repair should be added. There are no five-year follow-up reports. In the present study of 34 patients followed for at least five years, all had a myotomy from the apex of the chest through the high-pressure zone and all had a total fundoplication hernia repair, 16 with gastroplasty and 16 with a standard Nissen fundoplication. The length of the completion fundoplication is reduced to less than 0.5 cm to avoid problems of overcompetence. There were no operative deaths. Follow-up is 100% by clinical history, 82.4% by radiology, and 61.8% by manometry. Radiological follow-up showed no recurrence or reflux, although 1 patient had esophageal mucus retention. Thirty patients (88.2%) are eating normally without dysphagia or spontaneous pain. Two patients (5.9%) have mild dysphagia, and 1 of them also has mild spontaneous pain. One patient has major residual dysphagia, which is being treated conservatively, and 1 has required colon interposition. Good-quality results have been achieved in 94% of patients now followed 5 to 10.7 years.
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PMID:Extended esophageal myotomy and short total fundoplication hernia repair in diffuse esophageal spasm: five-year review in 34 patients. 354 14

Many centers besides radiography and endoscopy, perform manometric measurements in the diagnostics of diseases concerning esophagus and cardia. They which allow to determine esophageal body peristalsis, LES length with spatial distribution of pressures (Vector Volume). The aim of our study was the estimation of usefulness the esophageal and cardial computed manometry in disorders concerning motor activity of the upper part of gastrointestinal tract. In our hospital between March 1997 and March 1998 we examined 12 patients with cardial achalasia, 9 patients with hiatal hernia, 2 ones with features of gastroesophageal reflux without hernia and 1 patient with diffuse esophageal spasm. All patients were examined preoperatively, on the 7th postoperative day and postoperatively--after a month. Computer recording of pressures was made. In postoperative examination we revealed favourable improvement in gastroesophageal passage with marked decrease of LES pressures in patients after dilation. However in patients after Nissen's operation LES pressures exceeded upper normal range on the 7th day postoperatively, but they came back to normal range within a month after operation.
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PMID:[Manometric examinations in esophageal peristalsis disorders]. 1094 2