Randomized trial of total fundoplication and fundal mobilization with or without division of short gastric vessels: a short-term clinical evaluation.
OBJECTIVE
Evaluate short results after fundoplication procedure, concerning the division of short gastric vessels.


METHODS
A prospective randomization of 90 patients with indication for hiatoplasty and total fundoplication with fundus mobilization was performed. They were divided into two groups: no SGV division (group A, n= 46) and with SGV division (Group B, n=44), although in both groups the gastric fundus was mobilized to perform a floppy valve. Early outcome with clinical follow up (1 year) was observed.


RESULTS
Both groups were similar regarding preoperative parameters and severity of gastroesophageal reflux disease (GERD). No difference in morbidity was observed during hospital stay. Nevertheless, the median operating time was 80,2 minutes in group A and 94,1 minutes (p=0,021) in Group B. Transitory dysphagia during the first year was significantly lower in group B (46,6% versus 23,2%, p=0,012). However, in 12 months clinical outcome was similar in both groups (clinical symptoms of GERD, persistent dysphagia and reoperations).


CONCLUSIONS
There was no improvement in routine division of SGV in total fundoplication procedure when the gastric fundus was mobilized.
Farah
José Francisco de Mattos
JF
Department of Surgery, UNIFES, São Paulo, Brazil. josefarah@einstein.br
Grande
José Carlos Del
JC
Goldenberg
Alberto
A
Martinez
Júlio César
JC
Lupinacci
Renato Arione
RA
Matone
Jacques
J
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013270:Stomach / Q000098:blood supply*; D016896:Treatment Outcome