David B. Skinner

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Twenty-four pH monitoring the distal esophagus quantitates gastroesophageal reflux in a near physiologic setting by measuring the frequency and duration of acid exposure to the esophageal mucosa. Fifteen asymptomatic volunteers were studies with 24-hour pH and esophageal manometry. The normal cardia was more competent supine than in the upright position.(More)
We reviewed 53 consecutive patients with benign disease who underwent esophageal resection followed by colon interposition to assess operative morbidity and long-term results. Indications were gastroesophageal reflux in 32 patients, advanced motility disorders in eight, esophageal perforation in six, and strictures not related to reflux in seven. There were(More)
UNLABELLED Experience with gastroesophageal reflux in patients without prior operations has yielded understanding of pathophysiology, surgical techniques, and results. Less is known about patients with failed antireflux operations. This report of 61 patients undergoing repeat antireflux procedures addresses this issues. Not included are patients with(More)
The principles of en bloc resection for carcinoma can be adapted to neoplasms of the esophagus. The techniques of the operation are described. Among the 80 patients undergoing radical resection, there were nine (11%) hospital deaths within 30 days of operation. The actuarial survival rate was 24% at 3 years and 18% at 5 years. There have been no recurrences(More)
Diverticula of the thoracic esophagus are uncommon disorders. The indications for surgical intervention in asymptomatic or minimally symptomatic patients are unclear. Among 20 patients referred during a 20-year period, 6 were male and 14 female, with a median age of 65 years. Two had had previous diverticulectomies. Dysphagia was present in 9 (45%) and(More)
Ten patients with diverticula of the mid- or lower esophagus are reviewed with a focus on esophageal function, particularly motility, and its relation to surgical treatment. Median age is 56 years (range 16–79). There are 5 males and 5 females. The predominant symptoms were dysphagia and regurgitation, generally of 3 to 4 years' duration. All diverticula(More)
Seventy-seven patients with a primary complaint of persistent cough, wheezing, and/or recurrent pneumonia were evaluated for the presence of occult gastroesophageal reflux disease. Fifty-four patients (70%) had increased esophageal acid exposure on 24-hour pH monitoring of the distal esophagus. In 28% of these patients the respiratory symptoms were thought(More)
Using strict criteria for diagnosis, 23 patients having benign Barrett's esophagus, and 20 patients with adenocarcinoma arising in this epithelium have been analyzed. Evidence supports severe gastroesophageal reflux as a cause of Barrett's esophagus. Successful antireflux surgery leads to stabilization and possibly regression of the dysplasia in Barrett's(More)