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Effect of pregnancy on effectiveness of laparoscopic Nissen fundoplication

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Abstract

Background

Symptoms of gastroesophageal reflux disease (GERD) are experienced by up to 85% of pregnant women. Some young women on maintenance proton pump inhibitor (PPI) treatment are choosing surgery to stop their medical treatment and avoid severe symptoms during pregnancy. There are no reports describing the effect of pregnancy on the long-term efficacy of laparoscopic Nissen fundoplication. The aim of this study was to evaluate the effect of pregnancy on the efficacy of laparoscopic Nissen fundoplication.

Methods

This study surveyed 146 women of childbearing age with proven GERD who had undergone laparoscopic Nissen fundoplication from 1992 through 2002. The patients who became pregnant (group 1) were compared with those who did not (group 2).

Results

The study focused on 25 patients who became pregnant after surgery. Of these patients, 40% (n = 10) had chosen surgery as a way to discontinue PPI treatment before pregnancy. The mean time from laparoscopic Nissen fundoplication to pregnancy was 25.9 ± 4.6 months. A total of 19 patients (76%) had no reflux symptoms, whereas 5 (20%) required antacids during pregnancy. One patient (4%) experienced an acute intrathoracic stomach migration during her pregnancy and required emergency open surgery, which resulted in the loss of her fetus. After pregnancy, six patients (24%) had recurrence of GERD symptoms, and three (12%) required a redo fundoplication. The higher rate of GERD recurrence (24% vs 16.7%) and redo surgery (12% vs 4%) in group 1 did not reach statistical significance, but showed a definite trend.

Conclusion

For most patients, laparoscopic Nissen fundoplication is effective in controlling GERD symptoms during and after pregnancy.

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Acknowledgments

The authors acknowledge Leslie DiLuca and the Motility Laboratory technicians for assistance in data collection, and Catherine Gill Pottruff and Paula McKay for assistance in data collection, statistical support, and assistance in preparation of the manuscript.

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Authors and Affiliations

  1. Department of Surgery, St. Joseph’s Hospital, McMaster University, 50 Charlton Avenue E., Hamilton, Ontario, Canada, L8N 4A6

    L. Biertho, H. Sebajang, F. Bamehriz, K. Head & M. Anvari

  2. Department of Medicine, St. Joseph’s Hospital, McMaster University, 50 Charlton Avenue E., Hamilton, Ontario, Canada, L8N 4A6

    C. Allen

Authors
  1. L. Biertho
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  2. H. Sebajang
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  3. F. Bamehriz
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  4. K. Head
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  5. C. Allen
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  6. M. Anvari
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Corresponding author

Correspondence to M. Anvari.

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Biertho, L., Sebajang, H., Bamehriz, F. et al. Effect of pregnancy on effectiveness of laparoscopic Nissen fundoplication. Surg Endosc 20, 385–388 (2006). https://doi.org/10.1007/s00464-005-0225-3

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  • DOI: https://doi.org/10.1007/s00464-005-0225-3

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