title: Patient outcomes and dysphagia after laparoscopic antireflux surgery performed without use of intraoperative esophageal dilators.
abstract: Esophageal dilators (EDs) are commonly used during antireflux surgery but are a known cause of esophageal perforation. We hypothesized that the usage of ED during laparoscopic fundoplications (LFs) would not improve dysphagia rates or outcome. A retrospective review of 268 consecutive patients and a postoperative patient survey were performed to compare outcomes in patients undergoing LF. Eighty-nine patients had an ED placed and 179 did not. Significant postoperative dysphagia occurred in seven (8%) and six (3%), respectively (P = 0.123) and postoperative heartburn in five (6%) and three (2%), respectively (P = 0.865), in a mean 26.8-month follow-up. Patient survey results demonstrated good to excellent satisfaction in 89 per cent of patients in both groups. We conclude that the results of LF are equivalent with respect to control of heartburn and risk of dysphagia regardless of ED usage. Selective rather than routine use of EDs is recommended.
authors.affiliation: Department of Surgery and Biomedical Statistics Gundersen Lutheran, Medical Center, La Crosse, Wisconsin 54601, USA.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Walsh
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Landercasper
authors.forename: William C
authors.initials: WC
authors.lastname: Boyd
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Lambert
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Havlik
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology*; D004106:Dilatation; D005260:Female; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome