title: Laparoscopic antireflux surgery improves esophageal body motility in patients with severe reflux esophagitis.
abstract: OBJECTIVE
  This study was designed to clarify whether laparoscopic antireflux surgery (LARS) improves the esophageal body motility (EBM) in patients with reflux esophagitis.
  
  
  METHODS
  Thirty-five patients with gastroesophageal reflux disease (GERD) scheduled to undergo LARS were divided into a mild esophagitis group (ME; n = 18, Grade O:A:B = 7:10:1) and a severe esophagitis group (SE; n = 17, Grade C:D = 13:4), according to the Los Angeles classification of reflux esophagitis. The types of fundoplication (Nissen/Toupet) were 6/12 in the ME group and 4/13 in the SE group. Esophageal pH monitoring and manometry were performed before and 1 year after surgery.
  
  
  RESULTS
  The fraction time of a pH below 4 significantly decreased after surgery in both groups. The LES pressures did not change significantly after surgery in the ME group, but significantly increased in the SE group. The peristaltic amplitudes 18 and 13 cm above the LES did not change significantly after surgery in either group. The peristaltic amplitudes 8 and 3 cm above the LES did not change significantly after surgery in the ME group, but significantly increased after surgery in the SE group.
  
  
  CONCLUSIONS
  The preoperative EBM was not improved by LARS in patients with GERD and mild mucosal breaks in the esophagus, but the preoperative middle to distal EBM was improved by LARS in patients with GERD and severe mucosal breaks.
authors: Department of Surgery, School of Medicine, Kitasato University, 2-1-1, Asamizodai, Minami-ku, Sagamihara, Kanagawa, 252-0380, Japan, katada@kitasato-u.ac.jp.
authors: Natsuya
authors: N
authors: Katada
authors: Hiromitsu
authors: H
authors: Moriya
authors: Keishi
authors: K
authors: Yamashita
authors: Kei
authors: K
authors: Hosoda
authors: Shinichi
authors: S
authors: Sakuramoto
authors: Shiro
authors: S
authors: Kikuchi
authors: Masahiko
authors: M
authors: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000379:methods*; D050782:Esophageal pH Monitoring; D004942:Esophagitis, Peptic / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery*; D004947:Esophagus / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005769:Gastrointestinal Motility; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
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