Open AccessTotal esophagogastric dissociation in adult neurologically impaired patients with severe gastroesophageal reflux: an alternative approach
Author(s) -
Hazebroek E. J.,
Hazebroek F. W. J.,
Leibman S.,
Smith G. S.
Publication year - 2008
Publication title -
diseases of the esophagus
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 63
eISSN - 1442-2050
pISSN - 1120-8694
DOI - 10.1111/j.1442-2050.2008.00834.x
Subject(s) - medicine , reflux , gastrostomy , myotonic dystrophy , cerebral palsy , surgery , swallowing , pediatrics , disease , physical medicine and rehabilitation
SUMMARY Patients with neuromuscular impairment, such as cerebral palsy or myotonic dystrophy, often suffer from oropharyngeal neuromuscular incoordination and severe gastresophageal reflux (GER). In 1997, Bianchi proposed total esophagogastric dissociation (TEGD) as an alternative to fundoplication and gastrostomy to eliminate totally the risk of recurrence of GER in neurologically impaired children. Little information exists about the best management for adult patients with severe neurological impairment in whom recurrent GER develops after failed fundoplication. We present our experience in three adult patients with neurological impairment in whom TEGD with Roux‐en‐Y esophagojejunostomy and feeding gastrostomy was performed for permanent treatment of GER.