[Hiatus calibration decreases postoperative dysphagia after laparoscopic fundoplication: case-report study].
OBJECTIVE
The risk of dysphagia after antireflux surgery seems to be increased with laparoscopy compared with open surgery. Calibration of the hiatus is usually done by the surgeon's finger during open surgery. The aim of this study was to assess the results of laparoscopic calibration with a Fogarty balloon catheter.


METHODS
Between 1999 and 2001, 21 patients had a laparoscopic Toupet 240 degrees fundoplication with hiatus calibration using a 4 ml-inflated 8G Fogarty balloon catheter. These patients were compared with a group of 21 patients without hiatus calibration, matched for age, sex, preoperative dysphagia and esophageal dysmotility. Judgment criteria was early and/or late postoperative dysphagia (> 3 months).


RESULTS
Median follow-up was 13 months. The rate of early dysphagia with and without calibration were 66% and 48% respectively (NS). Median duration of early dysphagia with and without calibration were 25 and 43 days respectively (p = 0.05). No patient with calibration had late dysphagia. One patient (5%) without calibration had unexplained late dysphagia for 2 years. He had preoperative esophageal dysmotility without oesophagitis.


CONCLUSIONS
Hiatus calibration with a Fogarty balloon catheter decreased early postoperative dysphagia duration after Toupet laparoscopic fundoplication. This easily reproducible technical point standardizes the hiatus closure and should be recommended.
Sledzianowski
J F
JF
Service de chirurgie digestive, CHU Rangueil, 1, avenue J. Poulhès, 31043 Toulouse, France.
Suc
B
B
Lizza
N
N
Muscari
F
F
Gahnnem
Y
Y
Duffas
J P
JP
Fourtanier
G
G
D000328:Adult; D002138:Calibration; D002404:Catheterization; D003680:Deglutition Disorders / Q000209:etiology / Q000517:prevention & control*; D003964:Diaphragm / Q000033:anatomy & histology / Q000601:surgery*; D004947:Esophagus / Q000033:anatomy & histology / Q000601:surgery*; D005260:Female; D018662:Fundoplication / Q000009:adverse effects* / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D016896:Treatment Outcome
Le calibrage de l'orifice hiatal diminue la dysphagie postopératoire après la cure de reflux gastro-oesophagien par laparoscopie: étude cas-témoins.