This disorder, often associated with gastritis and hiatal hernia is present in Italy in about 10 million cases .
Of these about 10% is very treatable, recurrent and tends to chronicity, which may cause, after several years, the transformation of inflamed tissue in the esophagus and stomach cancer.
These cases, refractory to drug therapy, should undergo surgery. In most cases, where there is often a slow emptying of the stomach (digestion long after lunch), the intervention is that of gastro- duodenopexi with pilorotomia . This is
minimally invasive , it grossed a plastic between the stomach and duodenum after cutting, and separated the pyloric muscle, but allows the stomach to empty and deflate quickly after a meal.
This does not accumulate the acid in the stomach regurgitates into the esophagus, creating inflammation.
If there is also considerable hiatus hernia is repaired it.
commonly the first operation alone gives amazing results to those who had erniorrafie hiatus and / or gastro-esophageal plication that leave residues in the symptomatic patient.
's intervention with gastro-duodenopexi pilorotomia is safer when performed in open air (ie limited to the abdomen with an incision above) being used in laparoscopy little more in this case because it was deemed more risk involved in the pyloric and antrum of the stomach there is a rich blood supply and anomalous result of the gastro-duodenitis frequent basis and in many cases cronicizzata.Molti gastroenterologists criticano questo intervento senza mai chiedere al paziente se sta decisamente meglio dopo pochi o molti anni di seri disturbi (bruciori, dolori, eruttazioni, lenta digestione, ecc.).In qualche caso il gastroenterologo sconsiglia l’intervento ai pazienti che dopo anni di disturbi, tentativi multipli di uso di farmaci, gastroscopie, ecc. chiedono di essere operati affermando che questa operazione è vecchia, antica e che non si esegue più.Evidentemente non tengono in considerazione le discussioni e le pubblicazioni scientifiche internazionali dove la piloro plastica è sempre parte della disponibilità tecnica del chirurgo da sola o associata ad altre tecniche correttive (erniorrafia iatale, plicatura gastro-esofagea, ecc.).
La piloro Plastics are essential in many cases in which the emptying of the stomach is slow and often gives the dominant disorder of the stomach feel full even after three hours of dining or otherwise by pasto.I
n this case the only valid test to prove bad dynamics of the pylorus (spasm, hypertrophy) is the X-ray with barium swallow food that mimics a meal and stimulates the abnormal contraction of the pyloric muscle.
This phenomenon can not be seen and evaluated with endoscopy because the stomach is empty and free and not the physiological stimulus of food meal, which instead is the barium swallow. More than one out of ten citizens suffer from gastric and gastro-esophageal reflux e un 10%, come accennato sopra, è refrattario alle terapie mediche per cui oltre 100.000 italiani soffrono cronicamente di questo disturbo e corrono il pericolo, dopo diversi anni, di rischiare la brutta modifica a malattia tumorale.
La chirurgia in questo gruppo di pazienti offre un 90% di buon risultato correttivo ridando al paziente una ripresa digestiva normale con, in mano a un buon professionismo, un trascurabile rischio operatorio.
Questo dato il gastroenterologo lo può confermare, dopo 6 mesi - 1 anno, al controllo post-operatorio.
A proposito della critica mossa da diversi gastroenterologi, di eseguire la chirurgia con incisione addominale e non con la laparoscopia, oggi di gran moda, bisogna noted that throughout the modern world there is scientifically and clinically updated, in some cases, preference for surgery to traditional open as yet uncertain security better than with laparoscopy.
Even today there are debates and disputes between large groups about surgical safety, preferences, risks and benefits in certain cases, including surgical technique with "open" and laparoscopic surgery, so it is good for now and in some cases, being on more Traditional safe.
course, in cases where the gastric ulcer is caused by the bacterium "Helicobacter pylori" should be treated as a gastroenterologist for use before surgery.
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