Esophageal Lengthening Procedures
The concept of acquired short esophagus is possibly one of the most controversial aspects in surgery for benign esophageal disease with esophageal lengthening procedures being useful techniques in the armamentarium of an upper GI surgeon. Esophageal lengthening procedures are required when there is a less than 2.5 cm of intra-abdominal esophagus. Conditions often associated with this include chronic GERD, giant hernia, and presence of a stricture; however, ultimately the need for a Collis gastroplasty can only be determined intraoperatively. Type II mobilization of the esophagus is critical to gaining length in addition to careful determination of the gastroesophageal junction. The modified Collis gastroplasty holds the potential to decrease recurrence and wrap failure in the properly selected patient population. It is associated with minimal morbidity with most studies demonstrating equivalent quality of life outcomes in comparison with fundoplication-only cohorts.
KeywordsShort esophagus Collis gastroplasty Paraesophageal hernia Intrathoracic stomach Fundoplication Stapled gastroplasty Recurrence paraesophageal hernia Esophageal lengthening
- 9.Bremner RM, Bremner CG, Peters JH. Fundamentals of antireflux surgery. In: Peters JH, DeMeester TR, editors. Minimally invasive surgery of the foregut. 1st ed. St Louis: Quality Medical Publishing; 1994. p. 119–243.Google Scholar