Influence of spastic motor disorders of the esophageal body on outcomes from laparoscopic antireflux surgery.
BACKGROUND
The clinical outcomes of laparoscopic antireflux surgery (LARS) in patients with the spectrum of nonspecific spastic esophageal motor disorders (NSSDs) are not known.


METHODS
From a prospective database of patients undergoing LARS between 1997 and 2000, those with preoperative manometry at our institution and follow-up at ?6 months were identified.


RESULTS
Of the 121 patients, 35 had NSSDs. There were no differences in symptoms between groups preoperatively, but in the immediate postoperative period NSSD patients had more symptoms than nonspastic patients. At 18-month mean follow-up, NSSD patients reported significantly more heartburn (22% vs 7%), waterbrash (14% vs 4%), and medication usage (17% vs 5%) than nonspastic patients (p <0.05 for each). Despite this difference, nearly all patients reported subjective improvement postoperatively, and the degree of improvement was similar between groups.


CONCLUSIONS
Patients with NSSDs are more likely to have esophageal symptoms following LARS than subjects without these abnormalities. However, these patients still experience significant improvement in preoperative symptoms.
Winslow
E R
ER
Department of Surgery, Washington University School of Medicine, 660 South Euclid, WUMS Box 8109, St. Louis, MO 63110, USA. winslowe@msnotes.wustl.edu
Clouse
R E
RE
Desai
K M
KM
Frisella
P
P
Gunsberger
T
T
Soper
N J
NJ
Klingensmith
M E
ME
D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D016208:Databases, Factual; D015154:Esophageal Motility Disorders / Q000150:complications* / Q000378:metabolism; D004947:Esophagus / Q000737:chemistry / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods / Q000706:statistics & numerical data; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010535:Laparoscopy / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D008991:Monitoring, Physiologic; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000188:drug therapy; D011300:Preoperative Care / Q000379:methods / Q000706:statistics & numerical data; D011446:Prospective Studies; D016896:Treatment Outcome
D000897:Anti-Ulcer Agents