|Discussion in 'All Categories' started by Pawan Bajaj - Jun 10th, 2012 1:41 pm.|
|Burning and Choking ans indigestion - diagnosis from manometry- hypotensive Les with ineffective esophageal body motility|
re: hiatus hernia by Dr J S Chowhan - Jun 12th, 2012 7:23 am
Dr J S Chowhan
|Dear Mr Pawan Bajaj
We will advice you that in first line management you should go for surgery.
Giving surgical advice just reading the symptom of the patient online is not an easy task but in your case in our opinion you should go for partial fundoplication. Toupet fundoplication (posterior 270°) procedure with somewhat different indications as in yours.
Anterior 90° partial fundoplication for gastroesophageal reflux (GER) is better tolerated with fewer negative effects than the laparoscopic Nissen (LN) procedure, according to the results of a prospective, randomized trial "The 360° fundoplication that was first described by Nissen continues to be most commonly performed anti-GER procedure worldwide.
These early outcomes support the continued evaluation of this technique although longer-term follow-up is needed before this procedure can be suitable for routine clinical application in patient with hypotensive lower esophageal sphincter.
In our opinion if medical treatment does not give you good advantage you should go for any of the above partial fundoplication as esophageal manometry has shown that there is hypotensive lower esophageal sphincter and there is ineffective esophageal body motility.
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