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.
Similar content being viewed by others
References
Allen CJ, Parameswaram K, Belda J, Anvari M (2000) Reproducibility, validity, and responsiveness of a disease-specific symptom questionnaire for gastroesophageal reflux disease. Dis Esophagus13: 265–270
Anvari M, Allen CJ (2003) Five-year comprehensive outcomes evaluation in 181 patients after laparoscopic Nissen fundoplication. J Am Coll Surg 196: 51–57
Beckingham IJ, Cariem AK, Bornman PC, Callanan MD, Louw JA (1998) Oesophageal dysmotility is not associated with poor outcome after laparoscopic Nissen fundoplication. Br J Surg 85: 1290–1293
Bessell JR, Finch R, Gotley DC, Smithers BM, Nathanson L, Menzies B (2000) Chronic dysphagia following laparoscopic fundoplication. Br J Surg 87: 1341–1345
Chrysos E, Tsiassouis J, O Zoras, E Athanasakis, A Mantides, A Katsamouris, Xynos E (2003) Laparoscopic surgery for gastroesophageal reflux disease patients with impaired esophageal peristalsis: total or partial fundoplication? J Am Coll Surg 197: 8–15
Dallemagne B, Weerts JM, Jehaes C, Markiewicz S, Lombard R (1991) Laparoscopic Nissen fundoplication: preliminary report. Surg Laparosc Endosc 1: 138–143
Fibbe C, Layer P, Keller J, Strate U, Emmermann A, Zornig C (2001) Esophageal motility in reflux disease before and after fundoplication: a prospective, randomized, clinical, and manometric study. Gastroenterology 121: 5–14
Freys SM, Fuchs KH, Heimbucher J, Thiede A (1997) Tailored augmentation of the lower esophageal sphincter in experimental antireflux operations. Surg Endosc 11: 1183–1188
Granderath F, Kamolz T, Schweiger U, Pasiut M, Wykypiel H, Pointer R (2002) Quality of life and symptomatic outcome three to five years after laparoscopic Toupet fundoplication in gastroesophageal reflux disease patients with impaired esophageal motility. Am J Surg 183: 110–116
Hunter J (2004) Invited commentary. J Am Coll Surg 198: 869
Lund RJ, Wetcher GJ, Raiser F, Glaser K, Perdikis G, Gadenstatter M, Katada N, Filipi CJ, Hinder RA (1997) Laparoscopic Toupet fundoplication for gastroesophageal reflux disease with poor esophageal body motility. J Gastrointest Surg 1: 301–308
Mathew G, Watson DI, Myers JC, Holloway RH, Jamieson GG (1997) Oesophageal motility before and after laparoscopic Nissen fundoplication. Br J Surg 84: 1465–1469
Nissen R (1956) Eine einfache Operation zur Beeinflussung der Refluxoesophagitis. Schweiz Med Wochenschr 86: 590–592
Watson DI, Pike GK, Baigrie RJ, Mathew G, Devitt PG, Britten-Jones R, Jamieson GG (1997) Prospective double-blind randomised trial of laparoscopic Nissen fundoplication with division and without division of short gastric vessels. Ann Surg 226: 642–652
Author information
Authors and Affiliations
Corresponding author
Additional information
Presented at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) meeting, Fort Lauderdale, FL, 13–16 April 2005
Rights and permissions
About this article
Cite this article
Biertho, L., Sebajang, H. & Anvari, M. Effects of laparoscopic Nissen fundoplication on esophageal motility. Surg Endosc 20, 619–623 (2006). https://doi.org/10.1007/s00464-005-0256-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-005-0256-9