Laparoscopic partial posterior fundoplication improves poor oesophageal contractility in patients with gastrooesophageal reflux disease.
OBJECTIVE
To investigate the effect of partial posterior fundoplication on oesophageal contractility in patients with gastrooesophageal reflux disease (GORD).


METHODS
Follow-up study with 6 months of survey.


METHODS
University hospital, Austria.


METHODS
24 consecutive patients with GORD and poor oesophageal contractility.


METHODS
Laparoscopic partial posterior fundoplication. Oesophageal contractility was assessed manometrically.


METHODS
Changes in measurements of mean contraction amplitudes in the distal oesophagus, the number of contractions with amplitudes of less than 30 mmHg, the number of interrupted and simultaneous contractions, and the total number of defective contractions.


RESULTS
16 of the patients (67%) complained of dysphagia preoperatively, and none postoperatively. The mean (SEM) amplitudes in the distal oesophagus improved significantly (level 442.4 mmHg (3.5) compared with 31.8 mmHg (3.3), p = 0.03, and level 5-45.7 mmHg (3.8) compared with 32.6 mmHg (3.7), p = 0.02), the number of contractions with amplitudes below 30 mmHg decreased (18.0% (5.7) compared with 38.3% (6.2), p = 0.02), as did the number of interrupted or defected contractions (11.5% (3.6) compared with 26.3% (5.5), p = 0.03, and 29.5% (6.5) compared with 66.6% (5.1), p < 0.0001 respectively). There was no significant effect on the number of simultaneous waves (p = 0.11).


CONCLUSIONS
Partial posterior fundoplication improves poor oesophageal body motility. This results in improvement of preoperative dysphagia.
Wetscher
G J
GJ
2nd Department of Surgery, University of Innsbruck, Austria.
Glaser
K
K
Gadenstätter
M
M
Wieschemeyer
T
T
Profanter
C
C
Klinger
P
P
D000328:Adult; D000368:Aged; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009119:Muscle Contraction; D016896:Treatment Outcome