Examinando por Autor "Ochoa Quinteros, Kevin Marcelo"
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Ítem Acceso Abierto Funduplicatura de Nissen en enfermedad por reflujo gastroesofágico con metaplasia de Barrett refractaria al tratamiento: reporte de caso(Universidad Católica de Cuenca., 2023) Ochoa Quinteros, Kevin Marcelo; Aldás Erazo, Manuel Rafael; 0105217434Introduction: Gastroesophageal reflux disease occurs due to the involvement of the cardia and the esophagus as a result of gastric content regurgitation. Its global prevalence ranges from 10% to 30% of the population. Within this group, approximately 30-40% show resistance to proton pump inhibitors treatment, while other pharmacological measures have proven ineffective. However, fundoplication, regardless of the surgical technique used, has been shown to be effective in the long term, reversing the damage and resolving symptoms. Methodology: Descriptive retrospective case presentation. Objective: To describe a clinical case of a patient with treatment-resistant GERD with Barrett's metaplasia, treated surgically with Nissen fundoplication. Results: A 48-year-old female patient with a history of hiatal hernia presented with symptoms of epigastralgia, progressive dysphagia, and postprandial heartburn. Upper gastrointestinal endoscopy was performed, and upon macroscopic presence of metaplasia, a biopsy was performed, diagnosing Gastroesophageal reflux disease with Barrett's metaplasia. Treatment with proton pump inhibitors was initiated; however, no improvement in the epithelium was observed in the follow-up endoscopy, leading to the decision to perform surgical intervention using Nissen fundoplication as a definitive treatment. After one month, the patient showed positive progress, with a total improvement in her symptoms. Conclusion: Nissen fundoplication is established as a long-term therapeutic alternative with lower recurrence rates and complications compared to conventional medical treatment. However, further studies are still required to determine the optimal timing of this treatment. It is crucial to emphasize the importance of early intervention to prevent complications associated with GERD.
