Should the vagus nerves be isolated from the fundoplication wrap? A prospective study.
OBJECTIVE
To assess whether careful dissection and isolation of vagus nerves from the three-quarter Nissen fundoplication wrap (a periesophageal posterior gastric wrap 270 degrees in circumference) could modify the postoperative outcome and reduce postoperative gastric emptying disturbances.


METHODS
Open randomized control trial.


METHODS
University hospital.


METHODS
Forty-two patients with proved esophageal reflux and indication for surgery, after informed consent.


METHODS
A three-quarter Nissen fundoplication with (21 cases) or without (21 cases) dissection and exclusion of vagus nerves from the wrap.


METHODS
Standard questionnaire, acid reflux test, and gastric emptying study before and 3 months after surgery.


RESULTS
No difference was found between the groups. There was a correlation between preoperative and post-operative gastric emptying.


CONCLUSIONS
Exclusion of the vagus nerves from the three-quarter Nissen fundoplication wrap provides no advantage on postoperative gastric emptying and does not affect outcome of reflux surgery.
Peillon
C
C
Department of Surgery, Hôpital Charles Nicolle, Rouen, France.
Manouvrier
J L
JL
Labreche
J
J
Kaeffer
N
N
Denis
P
P
Testart
J
J
D000328:Adult; D000368:Aged; D005260:Female; D005746:Gastric Emptying; D005764:Gastroesophageal Reflux / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods; D014630:Vagus Nerve / Q000601:surgery