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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2017; 71(2): 156–160. doi:10.14735/amgh2017csgh.info04.

A first case of electrical stimulation therapy of lower esophageal sphincter indicated in the Czech Republic for implantation

Štefan Konečný1, Jiří Dolina Orcid.org  1, Zdeněk Beneš Orcid.org  2, Aleš Hep Orcid.org  1

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Summary

We report a case of a young 26-year-old man suffering from reflux symptoms and nonspecific esophageal dysmotility who was indicated to implantation of electrical stimulation therapy of the lower esophageal sphincter. This is the first case of use of this new surgical method for the treatment of gastroesophageal reflux disease in the Czech Republic. The patient underwent a variety of diagnostic tests, which failed to reveal other diseases besides gastroesophageal reflux disease and esophageal motility disorder. We exhausted the possibilities of conservative therapies, all of which did not significantly improve the patient’s condition.Subsequently, a consultation with a surgical department dealing with implantation of electrical stimulator of the esophagus resulted in the patient receiving approval for EndoStim implantation. Therefore, on October 14, 2015, professor Gutt, Memmingem Chirurgische Klinik, Germany, with experience in implanting 13 EndoStim devices, performed laparoscopic hiatal hernia repair and implanted the EndoStim in the patient. The surgery was well executed without any complications and the patient was in generally good condition after the operation released home. High-resolution esophageal manometry after surgery captured rare peristaltic waves and some improvement in dysmotility. The patient is now without proton pump inhibitor medication and subjectively feels better, and according to the latest MII-pH results, is without objective signs of reflux disease. During the postoperative period, the patient only once experienced vomiting; otherwise, there was a significant improvement in overall symptoms. The patient is waiting for further examination and readjustment of therapy to optimize the outcome.

Keywords

EndoStim, GERD, gastroesophageal reflux disease, reflux

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Literature

1. Vakil N, van Zanten SV, Kahrilas P et al. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol
2006; 101(8): 1900– 1920.
2. El-Serag HB, Sweet S, Winchester CC et al. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 2014; 63(6): 871– 880. doi: 10.1136/ gutjnl-2012-304269.
3. Rodríguez L, Rodriguez P, Gómez B et al. Electrical stimulation therapy of the lower esophageal sphincter is successful in treating GERD: final results of open-label prospective trial. Surg Endosc 2013; 27(4): 1083– 1092. doi: 10.1007/s00464-012-2561-4.
4. Rodríguez L, Rodriguez P, Gómez B et al. Long-term results of electrical stimulation of the lower esophageal sphincter for the treatment of gastroesophageal reflux disease. Endoscopy 2013; 45(8): 595– 604.doi: 10.1055/ s-0033-1344213.
5. Rodríguez L, Rodriguez P, Gómez B et al. Two-year results of intermittent electrical stimulation of the lower esophageal sphincter treatment of gastroesophageal reflux disease. Surgery 2015; 157(3): 556– 567.doi: 10.1016/ j.surg.2014.10.012.
6. Rodríguez L, Rodriguez P, Gómez B et al. Electrical stimulation therapy of the lower esophageal sphincter is successful in treating GERD: long-term 3-year results. Surg Endosc 2016; 30(7): 2666– 2672. doi:10.1007/ s00464-015-4539-5.
7. Kappelle WF, Bredenoord AJ, Conchillo JM et al. Electrical stimulation therapy of the lower esophageal sphincter for refractory gastro-oesophageal reflux disease – interim results of an international multicentre trial. Aliment Pharmacol Ther 2015;42(5): 614– 625. doi: 10.1111/ apt.13306.

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