Effect of laparoscopic Nissen fundoplication on symptoms and gastric myoelectric activity in gastroesophageal reflux disease.
BACKGROUND
Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease (GERD). The aim of this study was to determine whether laparoscopic fundoplication alters gastric myoelectric activity. Change of digestive symptoms was also assessed.


METHODS
Sixteen patients with GERD (2 males, 14 females, mean age: 53 years) undergoing a laparoscopic fundoplication participated. Electrogastrography (EGG) was assessed before and after the subject ingested water until full (water load). Symptoms of upper abdominal discomfort, early satiety, postprandial abdominal distension, nausea, vomiting, and anorexia were recorded. At a 2-month postoperative follow-up, preoperative tests were repeated.


RESULTS
The EGG was abnormal in 11 of 16 patients (69%) preoperatively and 6 of 16 patients (38%) postoperatively. The EGG changed from abnormal to normal in 5 of 16 patients (31%). The percentage of power at 3 cpm increased significantly during the fasting state postoperatively (29.9% vs. 21.2%, P < 0.05). There was a significant improvement in epigastric pain (P < 0.001), early satiety (P < 0.01), and postprandial fullness (P < 0.001).


CONCLUSIONS
Increased presence of normal 3 cpm activity is the predominant effect of fundoplication on gastric myoelectric activity. Dyspeptic symptoms are also significantly improved postoperatively.
Chen
Chien-Lin
CL
Division of Gastroenterology and Hepatology, Buddhist Tzu Chi General Hospital and Medical School, Hualien, Taiwan. clchen@tzuchi.org.tw
Reif
Michael E
ME
Orr
William C
WC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004326:Drinking; D004568:Electrodiagnosis; D005260:Female; D005583:Fourier Analysis; D018662:Fundoplication / Q000379:methods; D005764:Gastroesophageal Reflux / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016065:Myoelectric Complex, Migrating / Q000502:physiology*; D011446:Prospective Studies