Surgical Endoscopy

, Volume 22, Issue 11, pp 2518–2523

Total fundoplication controls acid and nonacid reflux: evaluation by pre- and postoperative 24-h pH–multichannel intraluminal impedance

  • Gianmattia del Genio
  • Salvatore Tolone
  • Federica del Genio
  • Gianluca Rossetti
  • Luigi Brusciano
  • Francesco Pizza
  • Landino Fei
  • Alberto del Genio
New Technology

DOI: 10.1007/s00464-008-9958-0

Cite this article as:
del Genio, G., Tolone, S., del Genio, F. et al. Surg Endosc (2008) 22: 2518. doi:10.1007/s00464-008-9958-0

Abstract

Background

Studies have demonstrated that Nissen fundoplication controls acid gastroesophageal reflux (GER). Combined 24-h pH and multichannel intraluminal impedance (MII-pH) allows detection of both acid and nonacid GER. Antireflux surgery is considered for any patient whose medical therapy is not efficient, particularly patients with nonacid gastroesophageal reflux disease (GERD). Nevertheless, fundoplication used to control nonacid reflux has not been reported to date.

Methods

In this study, 15 consecutive patients who underwent laparoscopic Nissen-Rossetti fundoplication had MII-pH both before and after the surgical procedure. The numbers of acid and nonacid GER episodes were calculated with the patient in both upright and recumbent positions.

Results

The 24-h pH monitoring confirmed the postoperative reduction of exposure to acid (p < 0.05). Postoperatively, the total, acid, and nonacid numbers of GER episodes were reduced (p < 0.05).

Conclusion

According to the findings, MII-pH is feasible and well tolerated. It provides an objective means for evaluating the effectiveness of Nissen-Rossetti fundoplication in controlling both acid and nonacid GER.

Keywords

Fundoplication GERD MII-ph pH monitoring 

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Gianmattia del Genio
    • 1
  • Salvatore Tolone
    • 1
  • Federica del Genio
    • 1
  • Gianluca Rossetti
    • 1
  • Luigi Brusciano
    • 1
  • Francesco Pizza
    • 1
  • Landino Fei
    • 1
  • Alberto del Genio
    • 1
  1. 1.First Division of General and Gastrointestinal SurgerySecond University of NaplesNaplesItaly

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