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Can Different Subsets of Ineffective Esophageal Motility Influence the Outcome of Nissen Fundoplication?

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Ineffective esophageal motility (IEM) in patients with gastroesophageal reflux disease includes three different subsets that may affect symptom profiles. Our aim was to assess symptoms and functional outcome in patients with erosive esophagitis according to different subsets of IEM, before and after Nissen fundoplication (NF).

Methodology

A retrospective study with prospective follow-up of 72 patients with reflux esophagitis and IEM in whom open NF was performed. Based on principal manometric esophageal body motility disorder, patients were divided in three groups: predominantly low-amplitude (LAC, N = 38), non-propulsive (NPC, N = 18), and simultaneous low-amplitude esophageal contractions (SC, N = 16). Patients underwent symptomatic questionnaire and stationary esophageal manometry before and 6 months, 1 year, and 3 years after surgery.

Results

Preoperatively, patients in NPC and SC groups had higher mean scores of dysphagia, without statistical significance as opposed to the LAC group (p = 0.239). Postoperative dysphagia occurred in 36 patients, without statistical significance between groups regarding dysphagia grades (p = 0.390). A longer duration of postoperative dysphagia was noted in the SC group (p < 0.05). Improvement of nadir values of contraction amplitudes in distal esophagus occurred postoperatively in all groups, significantly higher in LAC (p < 0.001).

Conclusion

Three years after NF, successful symptomatic and functional outcome was achieved in analyzed groups of patients with erosive esophagitis regardless of IEM subtype.

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Authors and Affiliations

  1. Department of Esophagogastric Surgery, First Surgical University Hospital, Clinical Center of Serbia, Koste Todorovica St 6, 11.000, Belgrade, Serbia

    Aleksandar P. Simić, Ognjan M. Skrobić, Vladimir M. Šljukić, Nenad R. Ivanović & Predrag M. Peško

  2. Department of General and Digestive Surgery, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Richard R. Gurski

  3. School of Medicine, University of Belgrade, Belgrade, Serbia

    Aleksandar P. Simić & Predrag M. Peško

Authors
  1. Aleksandar P. Simić
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  2. Ognjan M. Skrobić
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  3. Richard R. Gurski
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  4. Vladimir M. Šljukić
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  5. Nenad R. Ivanović
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  6. Predrag M. Peško
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Correspondence to Aleksandar P. Simić.

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Simić, A.P., Skrobić, O.M., Gurski, R.R. et al. Can Different Subsets of Ineffective Esophageal Motility Influence the Outcome of Nissen Fundoplication?. J Gastrointest Surg 18, 1723–1729 (2014). https://doi.org/10.1007/s11605-014-2607-0

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  • DOI: https://doi.org/10.1007/s11605-014-2607-0

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