Tratamiento Quirúrgico de la Enfermedad por Reflujo Gastro Esofágico y de las Hernias del Hiato Esofágico
DOI:
https://doi.org/10.31837/relatos/5Palabras clave:
reflujo gastroesofágico, tratamiento quirúrgico, cirugía antireflujo, cirugía laparosc´opica, hernia hiatal, casos clínicos, complicaciones operatoriasResumen
La enfermedad por reflujo gastroesofágico (ERGE) es una condición crónica y recurrente que se vincula al pasaje retrogrado del contenido gástrico, con o sin contenido duodenal, hacia el esófago y órganos adyacentes, con o sin lesión tisular (1).
Se caracteriza por su cronicidad y recurrencia, así como por ser una patología benigna, pero que afecta desfavorablemente la calidad de vida de los pacientes (2, 3, 4). La presentación clínica es muy variable, siendo sus síntomas típicos la pirosis y las regurgitaciones. Se reconocen como síntomas atípicos los respiratorios, otorrinolaringológicos y el dolor torácico entre
otros. En su evolución puede desarrollar complicaciones como una esofagitis de grado variable con ulceración
y estenosis, esófago de Barret y adenocarcinoma de esófago. La ERGE es una enfermedad frecuente, pero con prevalencias distintas en diferentes países. De acuerdo al estudio internacional DIGEST (Domestic/International Gastroentero-logy Surveillance
Study) un 7, 7% de la población refiere síntomas de reflujo gastroesofágico (5). Aproximadamente un 20% de los adultos norteamericanos tienen síntomas de reflujo gastroesofágico como pirosis y regurgitaciones ácidas por lo menos una vez a la semana (6, 7) En Uruguay la prevalencia estimada en la población urbana fue de 4, 69, mientras que para la población
hospitalaria fue de 11, 66%, utilizando el GERD (Gastro-esophageal reflux disease Questionnaire) (8) El tratamiento de la enfermedad por reflujo gastroesofágico ha tenido cambios significativos en las últimas dos décadas, motivados en un mejor estudio y conocimiento de sus aspectos fisiopatológicos, en la utilización de los inhibidores de la bomba de protones y en el desarrollo desde la década del 90 de la cirugía laparoscópica.
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