Dysphagia after the Rosetti fundoplication for gastroesophageal reflux
Sváb, J.; Krska, Z.; Lukás, M.; Horejs, J.
Rozhledy V Chirurgii Mesicnik Ceskoslovenske Chirurgicke Spolecnosti 79(7): 298-300
2000
ISSN/ISBN: 0035-9351 PMID: 11037706 Document Number: 514174
The authors describe as the possible cause of postoperative severe dysphagia after laparoscopic Rosetti's fundoplication low insertion of the cuff drawn behind the oesophagus to the anterior gastric wall. When the stomach is full the cuff is drawn into a spiral and the latter presses against the cardia and twists the cardia and abdominal oesophagus. For the condition unimpaired swallowing of the first mouthfuls is typical followed by severe dysphagia which can lead even to malnutrition. Common examinations may be normal except for the unaccountable dilatation of the oesophagus. An important role in detection of the cause is played by investigation of the passage of the barium suspension during swallowing with the patient in an upright position. The authors recommend insertion of the cuff as high as possible with careful mensuration of the permeability of the abdominal oesophagus during and at the end of surgery and fixation of the cuff to the diaphragm of diaphragmatic cruri.