Hiperemesis en mujer gestante portadora de banda gástrica / Hyperemesis in a pregnant woman with a gastric band

El 50-90% de las embarazadas tiene náuseas y vómitos a partir de la quinta, sexta semana de la gestación que habitualmente desaparecen en la semana 20. Sin embargo, en un 15-20% los síntomas continúan durante el tercer trimestre y en un 5% hasta el parto. La herniación gástrica tras la colocación de una banda gástrica ajustable cursa con una primera fase de pirosis por reflujo hasta desarrollar una intolerancia alimentaria total que se soluciona, sobre todo, en fases incipientes, abriendo el paso del estoma. Presentamos el caso de una gestante portadora de una banda gástrica con cuadro de vómitos e intolerancia oral, compatible clínicamente con el diagnóstico de “hiperemesis gravídica, en relación con herniación gástrica” (AU)

Nausea and vomiting occurs in 50-90% of pregnancies, usually beginning by 5-6 weeks of gestation and resolving by week 20. However, symptoms may persist through the third trimester in 15-20% and even until childbirth in 5%. The first phase of gastric herniation, as a complication of adjustable gastric lap band placement, is characterized by pyrosis due togastroesophageal reflux until complete feeding intolerance occurs. Improvement of this condition, mainly in the incipient phases, is achieved by complete band decompression. We present the case of a pregnant woman who underwent laparoscopic adjustable gastric banding who presented with nausea, vomiting and oral intolerance, a clinical picture compatible with hyperemesis gravidarum, related to gastric herniation (AU)

Calidad de vida tras funduplicatura por vía laparoscópica en el tratamiento del reflujo gastroesofágico / Quality of life after laparoscopic fundoplication for gastroesophageal reflux disease

Objetivo. Evaluar nuestros resultados en grado de satisfacción y calidad de vida de los pacientes intervenidos de reflujo gastroesofágico por vía laparoscópica. Pacientes y método. Estudio transversal en 49 pacientes consecutivos intervenidos de reflujo gastroesofágico por laparoscopia. Todos están intervenidos desde hace más de 6 meses y corresponden a casos del mismo cirujano. Se ha estudiado la morbilidad quirúrgica, el grado de satisfacción y la calidad de vida; para esta última, se remitió por correo, a todos los pacientes, los cuestionarios de calidad de vida SF-36 y GIQLI. Resultados. La edad media de los pacientes era de 40,5 años (rango, 23-71), 9 eran mujeres y 40, varones. A todos los pacientes se les practicó el cierre de ambas ramas del pilar diafragmático y funduplicatura floppy de 360°. No hubo ninguna reconversión. La tasa de complicaciones fue del 8,2% (un síndrome febril no filiado, una retención urinaria aguda, una hemorragia autolimitada y una hernia incisional en un orificio de un trocar). Respondieron a la encuesta 43 pacientes (87,7%). El grado de satisfacción fue de 8,7 (sobre 10), el 89,5% volvería a aceptar la intervención y el 94,6% la recomendaría a un familiar. Las puntuaciones obtenidas en el cuestionario SF-36 fueron similares a los valores poblacionales, salvo en la función física y en el dominio de dolor corporal, donde hubo diferencias significativas. La puntuación global media del cuestionario GIQLI fue de 110,8, similar a la de otros estudios publicados. Conclusiones. Aunque es un estudio de corte transversal, estos resultados preliminares indican un alto grado de satisfacción que se refleja en los estudios de calidad de vida (AU)

Objective. To evaluate our results in terms of satisfaction and quality of life in patients who underwent laparoscopic 360° fundoplication for gastroesophageal reflux disease. Patients and method. We performed a cross-sec-tional study of 49 consecutive patients who underwent laparoscopic 360° fundoplication for gastroesophageal reflux disease. All patients had been operated on more than 6 months previously by the same surgeon. Postoperative morbidity was recorded. Patients were sent the SF-36 and GIQLI quality of life questionnaires and were also asked about their degree of satisfaction with the surgery. Results. The mean age was 40.5 years (range, 2371). There were nine women and 40 men. All patients underwent a floppy 360° fundoplication and crural closure. There were no conversions. The complication rate was 8.2% (one case each of fever of unknown origin, acute urinary retention, self-limiting bleeding and hernia from a port). Forty-three patients completed the questionnaires (87.7%). Satisfaction with surgery was 8.7 points (out of 10), 89.5% would undergo surgery again and 94.6% would recommend it to a relative. The results of the SF-36 questionnaire were similar to population-based reference values except in the domains of physical functioning and bodily pain where statistically significant differences were found. The mean global GIQLI score was 110.8, which was similar to other studies published in the medical literature. Conclusions. Although this is a cross-sectional study, these preliminary results indicate a high degree of satisfaction with laparoscopic fundoplication, which was reflected in the results of the quality of life questionnaires (AU)

[Quality of life after laparoscopic fundoplication for gastroesophageal reflux disease]. / Calidad de vida tras funduplicatura por vía laparoscópica en el tratamiento del reflujo gastroesofágico.

OBJECTIVE: To evaluate our results in terms of satisfaction and quality of life in patients who underwent laparoscopic 360 degrees fundoplication for gastroesophageal reflux disease. PATIENTS AND METHOD: We performed a cross-sectional study of 49 consecutive patients who underwent laparoscopic 360 degrees fundoplication for gastroesophageal reflux disease. All patients had been operated on more than 6 months previously by the same surgeon. Postoperative morbidity was recorded. Patients were sent the SF-36 and GIQLI quality of life questionnaires and were also asked about their degree of satisfaction with the surgery. RESULTS: The mean age was 40.5 years (range, 23-71). There were nine women and 40 men. All patients underwent a floppy 360 degrees fundoplication and crural closure. There were no conversions. The complication rate was 8.2% (one case each of fever of unknown origin, acute urinary retention, self-limiting bleeding and hernia from a port). Forty-three patients completed the questionnaires (87.7%). Satisfaction with surgery was 8.7 points (out of 10), 89.5% would undergo surgery again and 94.6% would recommend it to a relative. The results of the SF-36 questionnaire were similar to population-based reference values except in the domains of physical functioning and bodily pain where statistically significant differences were found. The mean global GIQLI score was 110.8, which was similar to other studies published in the medical literature. CONCLUSIONS: Although this is a cross-sectional study, these preliminary results indicate a high degree of satisfaction with laparoscopic fundoplication, which was reflected in the results of the quality of life questionnaires.