[Can recurrent reflux disease following fundoplication be prevented by adding a vagotomy?].
Recurrent reflux disease is one of the main problems after fundoplication. Reducing gastric acid secretion by adding a vagotomy could theoretically be of beneficial value in controlling reflux. The clinical results of 109 patients were assessed 10 to 20 years after combined fundoplication and vagotomy for primary reflux disease. Indication for an additional vagotomy was severe reflux disease or increased gastric acid output in 56 and coexistent ulcer disease in 53 patients. Data from 64 patients (59.6%) were analyzed. Results were as follows: 17.2% had persistent or recurrent reflux disease, 9.5% needing medical treatment. The results were similar with different types of vagotomy: 18.5% and 14.8%, respectively for truncular vagotomy and pyloroplasty (27 pts.) 17.9% and 7.4%, respectively for selective gastric vagotomy and pyloroplasty (28 pts.), and 11.1% and 0%, respectively for proximal gastric vagotomy (9 pts.). Compared with the results after fundoplication alone, an additional vagotomy does not seem to prevent recurrent reflux disease.
Ackermann
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C
Margreth
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Muller
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005748:Gastric Fundus / Q000601:surgery*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012008:Recurrence; D014629:Vagotomy, Proximal Gastric / Q000379:methods*
Kann die rezidivierende Refluxkrankheit nach Fundoplikatio durch zusätzliche Vagotomie verhindert werden?