| Laparoscopic partial posterior fundoplication provides excellent intermediate results in GERD patients with impaired esophageal peristalsis. | |
| | |
MedLine Citation:
|
PMID: 10486608 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Gastroesophageal reflux disease (GERD) is frequently associated with impaired esophageal peristalsis, and many authorities consider this condition not suitable for Nissen fundoplication. METHODS: To investigate the outcome of antireflux surgery in the presence of impaired esophageal peristalsis, 78 consecutive GERD patients with poor esophageal contractility who underwent laparoscopic partial posterior fundoplication were studied. A standardized questionnaire, upper gastrointestinal endoscopy, esophageal manometry, and 24-hour pH monitoring were performed preoperatively and at a median of 31 months (range 6-57 months) postoperatively. Esophageal motility was analyzed for contraction amplitudes in the distal two thirds of the esophagus, frequency of peristaltic, simultaneous, and interrupted waves, and the total number of defective propagations. In addition, parameters defining the function of the lower esophageal sphincter were evaluated. RESULTS: After antireflux surgery, 76 patients (97%) were free of heartburn and regurgitation and had no esophagitis on endoscopy. The rate of dysphagia decreased from 49% preoperatively to 10% postoperatively (P < .001). Features defining impaired esophageal body motility improved significantly after antireflux surgery. The median DeMeester score on 24-hour esophageal pH monitoring decreased from 33.3 to 1.1 (P < .001). CONCLUSIONS: Partial posterior fundoplication provides an effective antireflux barrier in patients with impaired esophageal body motility. Postoperative dysphagia is diminished, probably because of improved esophageal body function. |
| | |
Authors:
|
M Gadenstätter; A Klingler; R Prommegger; R A Hinder; G J Wetscher |
Related Documents
:
|
17532708 - Pilot study of on-demand therapy with pantoprazole 20mg for long-term treatment in pati... 463278 - Nissen fundoplication. 6603888 - Urethral stricture after cardiac surgery. 18493528 - Long-term outcome of endoscopic balloon dilation in obstructive gastrointestinal crohn'... 12657168 - Important factors for a combined neurovascular team to consider in selecting a treatmen... 10496278 - Safety and factors related to survival after percutaneous endoscopic gastrostomy in als... |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Surgery Volume: 126 ISSN: 0039-6060 ISO Abbreviation: Surgery Publication Date: 1999 Sep |
Date Detail:
|
Created Date: 1999-09-28 Completed Date: 1999-09-28 Revised Date: 2004-11-17 |
Medline Journal Info:
|
Nlm Unique ID: 0417347 Medline TA: Surgery Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 548-52 Citation Subset: AIM; IM |
Affiliation:
|
Department of Surgery, University of Innsbruck, Austria. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Child Esophagus / physiopathology* Female Fundoplication / methods* Gastroesophageal Reflux / physiopathology*, surgery* Humans Laparoscopy / methods* Male Middle Aged Peristalsis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Functional capacity of the cirrhotic liver after partial hepatectomy in the rat.
Next Document: Expression of NOS II and its role in experimental small bowel ulceration in rats.