• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Persistent Gerd: Different Approach

Persistent Gerd: Different Approach

Alaa Eldin Badawy, consultant of surgery, Ahmed Talha, Lecturer of surgery, Amani El-bana, Lecturer of Medicine, Ahmed Hemimi, Assistant professor of radiology. Alexandria university hospitals, Alexandria Medical research institute and faculty of medicine

 

Objective: To evaluate the intra-abdominal esophageal length (IAEL) in GERD by MRI or multi-slice CT after upper GIT endoscopy in relation to GERD Q-questionnaire, also to see if this has an impact on the clinical course of the patient and response to medical or surgical therapy.

Methods: Seventy patients presented by symptomatic reflux disease according to GERD Q-questionnaire. Investigations included upper gastrointestinal endoscopy (excluding hiatal hernia cases), esophageal manometry, Multi-slice CT and/or MRI for the lower esophagus.
Basically all patients were treated medically, only cases of failed or poor response to medical treatment were converted to (group B) for surgery, rendering patients with good medical response as (group A). The esophageal intra-abdominal length was compared in both groups. Again GERD Q-questionnaire was used to assess the response to surgery weather Toupet fundoplication or 1800 posterior fundoplication plus anterior truncal vagotomy after crural repair in both groups.

Results: Medical treatment in the form of proton pump inhibitor and gastric prokinetic was successful in 50 cases (group A) with IAEL of 2 cms or more (mean 2.9+1.8 cms.) whole esophageal length (mean 38.5+1.8 cms.). Surgical treatment was done for 20 cases (group B) not well responding to medical treatment, IAEL was less than 2 cms. (mean 1.4+1.5 cms), whole esophageal length (mean 37.3 + 1.5 cms.).
Upper gastro-intestinal endoscopy demonstrated negative endoscopy reflux disease –NERD- cases to be 31 (7 of them were in group B). There was a statistically significant difference between both groups for the whole esophageal length using the independent groups T-test (“T” value of 2.6347, P=0.0104), similarly the IAEL was very statistically significantly shorter in group B (“T” value of 3.2934, P=0.0016).
GERD Q-questionnaire score in Group A had a mean of 10.3 + 1.7, while Group B had a mean of 14.6 + 1.6 that dropped postoperatively to 12.4 + 1.1 for Toupet group-10 cases- (extremely statistically significant drop T= 3.8957, P=0.0006) and to 10.8 + 1.5 for the group where anterior truncal vagotomy was added (10 cases), with cessation of post-operative prokinetics and proton pump inhibitors in both surgical groups. There is still a statistically significant drop of the score between the two surgical techniques ( T= 2.72, P=0.014) with much improvement in symptoms and no significant side effects for adding anterior truncal vagotomy.

Conclusion: In view of evidence based medicine IAEL of approximately 1 cm. in symptomatic GERD responded better to anti-reflux surgery with cessation of postoperative medication, results were enhanced if anterior truncal vagotomy was added to the partial posterior anti-reflux procedure. Though non-invasive, multi-slice CT and MRI can plan GERD management.
 


Session Number: Poster – Poster Presentations
Program Number: P184
View Poster

74

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals