Effects of laparoscopic Nissen fundoplication on esophageal motility: long-term results.
BACKGROUND
This study aimed to evaluate the long-term impact of laparoscopic Nissen fundoplication on esophageal motility in patients with preoperative esophageal dysmotility.


METHODS
This study prospectively followed 580 patients who underwent laparoscopic Nissen fundoplication between 1992 and 1999. Esophageal manometry, 24-h pH monitoring, and symptom score assessment were performed before surgery, then 6 months, 2 years, and 5 years after surgery. Preoperatively, 533 of the patients (93.5%) had normal esophageal contractile pressure (group 1), whereas 38 of the patients (6.5%) had reduced contractile pressure (<30 mmHg) (group 2).


RESULTS
Esophageal contractile pressures increased significantly in the patients with low preoperative values, whereas it remained unchanged in the patients with normal preoperative contractile pressures. Both groups reported a significant reduction in the dysphagia symptom score after surgery.


CONCLUSIONS
Nissen fundoplication produces a significant long-lasting increase in esophageal contractile pressures in patients with preoperative esophageal dysmotility (i.e., contractile pressure lower than 30 mmHg). Preoperative esophageal dysmotility is therefore not a contraindication to laparoscopic Nissen fundoplication.
Biertho
L
L
Centre for Minimal Access Surgery, St. Joseph's Healthcare, McMaster University, Hamilton, Ontario, L8N 4A6, Canada.
Sebajang
H
H
Anvari
M
M
D000328:Adult; D003680:Deglutition Disorders / Q000209:etiology; D015154:Esophageal Motility Disorders / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D004947:Esophagus / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010535:Laparoscopy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011312:Pressure; D011446:Prospective Studies