Transoral incisionless fundoplication as rescue therapy for gastroesophageal reflux in a lung transplant recipient

Q3 Medicine

VideoGIE Pub Date : 2025-02-21 DOI:10.1016/j.vgie.2025.02.003

William King MD , Hannah Zuercher MD , Manuel Amaris MD , Amir Emtiazjoo MD , Mindaugas Rackauskas MD, PhD , Bashar Qumseya MD, MPH

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引用次数: 0

Abstract

Background and Aims

A patient with a prior lung transplant and surgical fundoplication had severe recurrent gastroesophageal reflux disease (GERD) and chronic retrograde microaspiration, which both threatened his graft function and elevated his risk for retransplant. He was deemed a poor candidate for surgical fundoplication. We therefore aimed to perform a transoral incisionless fundoplication (TIF).

Methods

The gastroesophageal flap valve was loose on diagnostic esophagogastroduodenoscopy. We used a plication device to repair the existing fundoplication, forming a 270°, 3-cm wrap using 12 H-type fasteners.

Results

Erosive esophagitis improved from Los Angeles grade C to A and acid exposure time from 30% to 5%. Heartburn symptoms resolved. He underwent repeat lung transplant.

Conclusions

The video in this case demonstrates the technique for TIF after surgical fundoplication. This case also supports the use of TIF as rescue therapy for post-lung transplant GERD.

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经口无切口复底术治疗胃食管反流一例肺移植患者

背景和AimsA患者既往有肺移植和手术盆底重叠，有严重的复发性胃食管反流病（GERD）和慢性逆行微吸，这两种疾病都威胁到其移植物功能，增加了其再次移植的风险。他被认为不适合进行手术。因此，我们的目的是进行一个经口无切口的根底复制（TIF）。方法诊断性食管胃十二指肠镜检查胃食管瓣瓣松动。我们使用一个应用设备修复现有的基础重复，形成一个270°，3厘米包裹使用12个h型紧固件。结果糜烂性食管炎的洛杉矶分级从C级提高到A级，酸暴露时间从30%提高到5%。胃灼热症状消失。他接受了多次肺移植手术。结论本病例的视频演示了手术后TIF的技术。本病例也支持将TIF作为肺移植后GERD的抢救治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.