A study of factors responsible for the efficacy of fundoplication in the treatment of gastro-oesophageal reflux.
Forty-one patients were followed up for a median 14 months after Nissen fundoplication. Patients were questioned regarding their symptoms and 83% considered the surgery a complete success. Oesophageal manometry was performed before and after surgery. Median pre-operative lower oesophageal sphincter pressure (LOSP) was 5.5 mmHg; following operation median LOSP was 14 mmHg. The ability of the lower oesophageal sphincter (LOS) to relax with swallow was impaired by fundoplication; the median residual lower oesophageal sphincter pressure (RLOSP) was 0 mmHg prior to surgery and 3.5 mmHg following operation. Fundoplication appears to superimpose a zone of constant pressure on the lower oesophageal sphincter and this may be a further factor responsible for the efficacy of surgery.
D000293:Adolescent; D000328:Adult; D000368:Aged; D004943:Esophagogastric Junction / Q000503:physiopathology / Q000601:surgery; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011795:Surveys and Questionnaires