title: Effect of Nissen fundoplication on gastric motor and sensory functions.
abstract: OBJECTIVE
  Bloating, abdominal pain, and early satiety have been reported in up to 30% of patients after Nissen fundoplication. We hypothesized that these postsurgical complications in children and young adults are linked to either the effects of surgery on gastric sensation, compliance or motor function or to preexisting physiological abnormalities.
  
  
  METHODS
  We prospectively evaluated the effect of Nissen fundoplication on gastric sensory and motor functions in 13 children with gastroesophageal reflux. Gastric barostat and mixed meal gastric emptying studies were performed before surgery in all patients and were repeated after surgery in 8 and 9 children, respectively.
  
  
  RESULTS
  Thirteen patients (median age, 7 years; range, 6 months to 18 years) underwent open Nissen (n = 6) or laparoscopic Nissen fundoplication (n = 7). After fundoplication, patients had significantly higher minimal distending pressure values (10 mm Hg vs 3 mm Hg pre-Nissen, respectively; P < 0.001), reduced gastric compliance (slope values of 8.39 mm Hg vs 9.15 mm Hg, respectively, P < 0.001) and significantly higher pain scores (P < 0.001). Presurgery and postsurgery gastric emptying at 60, 90 and 120 minutes after feeding showed no significant changes.
  
  
  CONCLUSIONS
  After Nissen fundoplication, children with gastroesophageal reflux manifest the following: (1) reduction in gastric compliance, (2) increase in minimal gastric distending pressure, (3) exacerbation of the sensations discomfort with gastric distension and (4) no effect on gastric emptying.
authors.affiliation: Division of Gastroenterology, Department of Pediatrics, The Ohio State University College of Medicine and Public Health, Columbus, USA. mousah@pediatrics.ohio-state.edu
authors.forename: Hayat
authors.initials: H
authors.lastname: Mousa
authors.forename: Donna A
authors.initials: DA
authors.lastname: Caniano
authors.forename: Maya
authors.initials: M
authors.lastname: Alhajj
authors.forename: Laurie
authors.initials: L
authors.lastname: Gibson
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Lorenzo
authors.forename: Larry
authors.initials: L
authors.lastname: Binkowitz
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004435:Eating; D005260:Female; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods; D005746:Gastric Emptying / Q000502:physiology*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D011312:Pressure; D011446:Prospective Studies; D012677:Sensation / Q000502:physiology*