By Jon C. Gould, W. Scott Melvin
The final healthcare professional was once first brought to laparoscopy approximately twenty years in the past. In those prior 20 years, there was an evolution within the symptoms, ways, and results for the surgical operation of many stipulations and ailments. the talk concerning the optimum procedure maintains. regardless of all the advances which have been made in the course of the 'evolution of the laparoscopic revolution', there's nonetheless development to be made. This factor will learn the heritage of the minimally invasive surgical method of various stipulations, ongoing parts of controversy, and destiny instructions.
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Extra info for Advances and Controversies in Minimally Invasive Surgery, An Issue of Surgical Clinics (The Clinics: Surgery)
In a summary of several series, complete regression occurred in only 6 patients, with all but 1 coming from one series. Thirty-one patients showed some decrease in the length of Barrett’s epithelium, but only 6 had a decrease in length of more than 1 cm. Furthermore, 6 patients went on to develop adenocarcinoma of the esophagus. In contrast, several studies are now showing regression with surgical therapy. In some series, up to 60% of patients have experienced visual regression and 40% have experienced histologic regression [50,51].
Advocates of minimally invasive approaches cite many other beneﬁts, including improved visualization of the hiatus, easier esophageal mobilization high into the mediastinum, and decreased pulmonary complications. They also suggest that the impact of surgery is lessened in these elderly patients who have frequent medical comorbidities. Draaisma and colleagues  reviewed 32 published studies and found a signiﬁcantly shorter LOS (3 days laparoscopic versus 10 days open). 7%), although the ranges for these values overlapped signiﬁcantly.
Maziak and colleagues  described 94 patients undergoing thorough preoperative evaluation and found 94% had some degree of symptoms and further that 36% of the patients had erosive esophagitis. ’’ In the past several years, investigators have questioned past surgical dictum and revisited deﬁning the natural history of PEHs. Few studies exist that describe outcomes in unoperated patients. Allen and colleagues  described nonoperative management in 23 patients, who were followed for a mean of 78 months, with none developing acute complications requiring emergent operation.
Advances and Controversies in Minimally Invasive Surgery, An Issue of Surgical Clinics (The Clinics: Surgery) by Jon C. Gould, W. Scott Melvin