Effects of laparoscopic Nissen fundoplication on esophageal motility: long-term results.

Abstract

BACKGROUND:

This study aimed to evaluate the long-term impact of laparoscopic Nissen fundoplication on esophageal motility in patients with preoperative esophageal dysmotility.

METHODS:

This study prospectively followed 580 patients who underwent laparoscopic Nissen fundoplication between 1992 and 1999. Esophageal manometry, 24-h pH monitoring, and symptom score assessment were performed before surgery, then 6 months, 2 years, and 5 years after surgery. Preoperatively, 533 of the patients (93.5%) had normal esophageal contractile pressure (group 1), whereas 38 of the patients (6.5%) had reduced contractile pressure (<30 mmHg) (group 2).

RESULTS:

Esophageal contractile pressures increased significantly in the patients with low preoperative values, whereas it remained unchanged in the patients with normal preoperative contractile pressures. Both groups reported a significant reduction in the dysphagia symptom score after surgery.

CONCLUSION:

Nissen fundoplication produces a significant long-lasting increase in esophageal contractile pressures in patients with preoperative esophageal dysmotility (i.e., contractile pressure lower than 30 mmHg). Preoperative esophageal dysmotility is therefore not a contraindication to laparoscopic Nissen fundoplication.

• Authors: L Biertho, H Sebajang, M Anvari
• Journal: Surgical endoscopy (Surg Endosc) Vol. 20 Issue 4 Pg. 619-23 (Apr 2006) ISSN: 1432-2218 [Electronic] Germany
• PMID: 16508818 (Publication Type: Journal Article)

Topics

• Adult
• Deglutition Disorders (etiology)
• Esophageal Motility Disorders (complications, physiopathology, surgery)
• Esophagus (metabolism, physiopathology)
• Female
• Fundoplication
• Gastroesophageal Reflux (etiology, physiopathology)
• Humans
• Hydrogen-Ion Concentration
• Laparoscopy
• Longitudinal Studies
• Male
• Middle Aged
• Monitoring, Physiologic
• Pressure
• Prospective Studies