Antireflux Surgery by Lee L. Swanstrom, Christy M. Dunst

By Lee L. Swanstrom, Christy M. Dunst

This quantity offers a entire, cutting-edge evaluate of the most important matters particular to the sphere of antireflux surgical procedure. It offers unparalleled educational aspect relating to functionality of antireflux surgical procedure from major esophageal surgeons worldwide. This quantity represents the single source of its variety committed in particular to the problems precise to antireflux surgical procedure. it's wealthy intimately and important illustrations that tutor surgeons in right method in addition to offering the reasoning in the back of quite a few strategies. Written through specialists within the box, Antireflux surgical procedure is of serious worth to working towards surgeons who practice gastrointestinal surgical procedure, scientific scholars, surgical citizens, and fellows.

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Oxyntocardiac epithelium is particularly immune to cancer because it does not develop intestinal metaplasia [28]. It is therefore a stable epithelium that is highly desirable because it is resistant to acid, carcinogens, and agents in the gastric contents that induce intestinal metaplasia. Cardiac epithelium is 22 P. Chandrasoma and J. Guo Fig. 4 Similar diagram of a patient with severe reflux and a long segment of columnar lined esophagus with intestinal metaplasia limited to the proximal region.

Br J Surg. 1950;38:175–82. 36. Barrett NR. The lower esophagus lined by columnar epithelium. Surgery. 1957;41:881–94. 37. Allison PR, Johnstone AS. The oesophagus lined with gastric mucous membrane. Thorax. 1953;8:87–101. 38. Morson BC, Belcher BR. Adenocarcinoma of the oesophagus and ectopic gastric mucosa. Br J Cancer. 1952;6:127–30. 39. Rex DK, Cummings OW, Shaw M, Cumings MD, Wong RKH, Vasudeva RS, Dunne D, Rahmani EY, Helper DJ. Screening for Barrett’s esophagus in colonoscopy patients with and without heartburn.

As such, the squamo-oxyntic gap changes in only one direction—increase in length. In autopsy studies of people who have died without symptoms of reflux disease during life, the squamo-oxyntic gap varies from zero to less than 1 cm [19, 29]. If assessed by measured biopsies distal to the endoscopic gastroesophageal junction in patients with heartburn undergoing endoscopy, the gap is usually also less than 1 cm. This gap is limited to the dilated distal esophagus that is often mistaken for proximal stomach by present endoscopic criteria [2].

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