Journal of clinical gastroenterology
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J. Clin. Gastroenterol. · Jan 2012
Impact of total fundoplication on esophageal transit: analysis by combined multichannel intraluminal impedance and manometry.
Laparoscopic total fundoplication is considered the most effective surgical option for gastroesophageal reflux (GER) disease. Some authors assume that total fundoplication may expose the patient to delayed transit of the swallowed bolus and increased risk of dysphagia, particularly when peristaltic dysfunction is present. We undertook this study to evaluate by means of combined multichannel intraluminal impedance and esophageal manometry (MII-EM) the impact of fundoplication on esophageal physiology. An objective measurement of the influence of the total wrap on bolus transit may be helpful in refining the optimal antireflux wrap (ie, partial vs. total). ⋯ Laparoscopic Nissen-Rossetti is effective in controlling both acid and nonacid GER without impairment of esophageal function. Appropriate preoperative investigation, meticulous patient selection and correct surgical technique are extremely important in securing good results.
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J. Clin. Gastroenterol. · Jan 2012
Same-day bowel cleansing regimen is superior to a split-dose regimen over 2 days for afternoon colonoscopy: results from a large prospective series.
Conventional bowel preparation for afternoon colonoscopy requires an oral agent the day before the procedure. Bowel cleansing given only on the day of the colonoscopy has never been attempted. The aims of this study were to compare the efficacy of bowel cleansing, impact on activities of daily living (ADLs), side effects, and patient preference of a same-day regimen with a 2-day regimen. ⋯ Same-day bowel preparation is feasible, safe, and more effective than a split-dose regimen. It has fewer adverse events and is preferred by patients.