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PURPOSE Oncologic concerns from high wound recurrence rates prompted a multi-institutional randomized trial to test the hypothesis that disease-free and overall survival are equivalent, regardless of whether patients receive laparoscopic-assisted or open colectomy. METHODS Eight hundred seventy-two patients with curable colon cancer were randomly assigned(More)
OBJECTIVE The authors laparoscopic approach for a Nissen fundoplication is presented. SUMMARY BACKGROUND DATA The technique has been undertaken in 155 patients over 29 months, with 137 patients having been observed for more than 3 months. METHODS Three hundred sixty degree fundoplication was undertaken using three or four sutures to secure the wrap.(More)
INTRODUCTION Laparoscopic approach for colorectal resections is gaining popularity. Internal small bowel herniation (SBH) through a mesenteric defect has been described and, although rare, is a severe complication. The aim of this study was to evaluate the incidence and outcome of internal hernias after laparoscopic colorectal resection. MATERIAL AND(More)
OBJECTIVE To provide a comprehensive follow-up of 381 patients after laparoscopic Nissen fundoplication (LNF) using a technique of minimal paraesophageal dissection. METHODS Patients underwent a 24-hour pH recording, esophageal manometry, and symptom score assessment for six symptoms of gastroesophageal reflux disease preoperatively. To date, 260 patients(More)
Laparoscopic surgery is not being applied in a widespread manner in the management of benign or malignant colorectal disorders. This is a prospective comparison of 279 patients who underwent elective colorectal surgery. Colorectal diseases included inflammatory bowel, diverticular disease, colonic inertia, polyps, and rectal prolapse. Data included 136(More)
BACKGROUND Very few randomized controlled trials (RCTs) have compared laparoscopic Nissen fundoplication (LNF) to proton pump inhibitors (PPI) medical management for patients with chronic gastroesophageal reflux disease (GERD). Larger RCTs have been relatively short in duration, and have reported mixed results regarding symptom control and effect on quality(More)
Achalasia is dominated by injury to inhibitory nerves. As intramuscular interstitial cells of Cajal (ICC-IM) are proposed to form functional units with nitrergic nerves, their fate in achalasia may be critically important. We studied the relationship between loss of nitrergic nerves and injury to ICC-IM in patients with achalasia and determined associations(More)
BACKGROUND To date, few studies have examined the effect of morbid obesity on the outcome of laparoscopic antireflux surgery and results have been conflicting. The aim of this work was to study the outcome of laparoscopic Nissen fundoplication (LNF) in patients with body mass index (BMI) >or= 35. METHODS We prospectively followed 70 patients (15 men, 55(More)
To better understand the relationship between cholinergic and nitrergic (NO) innervation in the regulation of proximal gastric (fundic) tone in vivo, the effects of nitric oxide synthase blockade on fundic tone were studied in conscious dogs using vagal cooling and an electronic barostat. Vagal cooling, atropine (0.05 mg kg-1 i. v. bolus) and hexamethonium(More)
BACKGROUND A randomized controlled trial (RCT) investigated patients with gastroesophageal reflux disease (GERD) who were stable and symptomatically controlled with long-term medical therapy to compare ongoing optimized medical therapy with laparoscopic Nissen fundoplication (LNF). METHODS Of the 180 patients eligible for randomization, 104 gave informed(More)