Abstract
Background: An effort was made to assess the respiratory outcomes of laparoscopic Nissen fundoplication (LNF).
Methods: Prospective follow-up of 69 patients undergoing LNF for gastroesophageal reflux disease. Outcomes included pulmonary function testing, 24-h pH recording, esophageal manometry, and symptom assessment.
Results: There was an improvement (p < 0.0001) in heartburn and cough scores. There was a significant fall in spirometry (p < 0001), diffusing capacity (p < 0.0001), and respiratory muscle strength (p < 0.0001) 36 h after surgery, which had returned to baseline by 1 month. At 6 months, the patients (n= 16) with impaired preoperative diffusing capacity showed improvement (17.8 ± 3.7 to 19.8 ± 4.6 ml/min/mmHg, p= 0.0245).
Conclusion: Patients undergoing LNF have impaired gas exchange before surgery which tends to improve 6 months after surgery. There is an early reversible impairment in respiratory function due to diaphragm dysfunction. Patients with a preoperative 1-s forced expired volume > 1.5, or 50% predicted, are unlikely to develop signficant early respiratory complication.
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Received: 22 April 1996/Accepted: 9 July 1996
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Anvari, M., Allen, C. & Moran, L.A. Immediate and delayed effects of laparoscopic Nissen fundoplication on pulmonary function. Surg Endosc 10, 1171–1175 (1996). https://doi.org/10.1007/s004649900272
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DOI: https://doi.org/10.1007/s004649900272