Stapled-wedge Collis gastroplasty for the shortened esophagus.

Overview

BACKGROUND: Minimally invasive Collis gastroplasty is an established technique for managing the shortened esophagus. The purpose of this report is to describe our new technique, the wedge gastroplasty, and report the short-term outcomes. METHODS: All patients (n = 143) undergoing laparoscopic fundoplication from May 2000 to March 2001 were assessed intraoperatively for shortened esophagus. After mediastinal dissection, 15 patients with inadequate intraabdominal esophageal length underwent wedge gastroplasty. Preoperative symptoms, operative times, and short-term outcomes were evaluated. RESULTS: Mean operative time was 184 +/- 36 minutes (range 138 to 258). There was 1 cervical esophageal tear from bougie passage and no other minor or major complications. At 6 weeks, there was more improvement in esophageal symptoms compared with extraesophageal symptoms. CONCLUSIONS: Wedge gastroplasty is effective in decreasing symptoms in patients with shortened esophagus and takes less time to perform than other gastroplasty techniques. Further study is needed to assess long-term outcomes.