Tags

Type your tag names separated by a space and hit enter

[Nissen and Toupet laparoscopic fundoplication in patients with gastroesophageal reflux and motility disorders of the distal esophagus].
Chirurg 2002; 73(3):230-4C

Abstract

INTRODUCTION

A Nissen fundoplication for gastrooesophageal reflux disease may more often lead to persistent dysphagia than a Toupet fundoplication. The aim of this study was to assess the results of laparoscopic Nissen versus Toupet fundoplication in patients with reflux disease and impaired distal esophageal motility.

PATIENTS AND METHODS

In 15 patients a laparoscopic Nissen and in 17 a laparoscopic Toupet fundoplication was carried out. Criteria for an impaired motility of the distal esophagus were a mean amplitude of < 30 mm Hg of swallow-induced contractions, or > 33% non-propulsive or non-transmitted contraction waves. Before surgery, heartburn, dysphagia, regurgitation and other symptoms were scored and endoscopic, manometric and 24 hour pH-metric investigations performed. Patients were reinvestigated 3 to 30 (median 15) months after Nissen and 3 to 42 (median 7) months after Toupet fundoplication.

RESULTS

After Nissen as well as after Toupet fundoplication heartburn was significantly less frequent, whereas dysphagia and all other symptom-scores remained unchanged. In the 26 patients reinvestigated manometrically, the resting pressure of the lower esophageal sphincter was significantly higher following both operations and the residual sphincter pressure upon swallowing higher only after Nissen fundoplication. The amplitude of swallow-induced contractions and the percentages of non-propulsive and non-transmitted contraction waves were not significantly changed after either operation. In the 23 patients restudied pH-metrically, reflux activity was significantly reduced after both Nissen and Toupet fundoplication.

CONCLUSION

In patients with reflux disease and impaired distal esophageal motility, laparoscopic Nissen and Toupet fundoplication both yielded satisfactory results and neither operation led to increased dysphagia.

Authors+Show Affiliations

Klinische Abteilung für Allgemeinchirurgie, Universitätsklinik für Chirurgie, Wien, Osterreich.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

11963496

Citation

Puhalla, H, et al. "[Nissen and Toupet Laparoscopic Fundoplication in Patients With Gastroesophageal Reflux and Motility Disorders of the Distal Esophagus]." Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen, vol. 73, no. 3, 2002, pp. 230-4.
Puhalla H, Lenglinger J, Bischof G, et al. [Nissen and Toupet laparoscopic fundoplication in patients with gastroesophageal reflux and motility disorders of the distal esophagus]. Chirurg. 2002;73(3):230-4.
Puhalla, H., Lenglinger, J., Bischof, G., Miholic, J., Függer, R., & Stacher, G. (2002). [Nissen and Toupet laparoscopic fundoplication in patients with gastroesophageal reflux and motility disorders of the distal esophagus]. Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen, 73(3), pp. 230-4.
Puhalla H, et al. [Nissen and Toupet Laparoscopic Fundoplication in Patients With Gastroesophageal Reflux and Motility Disorders of the Distal Esophagus]. Chirurg. 2002;73(3):230-4. PubMed PMID: 11963496.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Nissen and Toupet laparoscopic fundoplication in patients with gastroesophageal reflux and motility disorders of the distal esophagus]. AU - Puhalla,H, AU - Lenglinger,J, AU - Bischof,G, AU - Miholic,J, AU - Függer,R, AU - Stacher,G, PY - 2002/4/20/pubmed PY - 2002/6/29/medline PY - 2002/4/20/entrez SP - 230 EP - 4 JF - Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen JO - Chirurg VL - 73 IS - 3 N2 - INTRODUCTION: A Nissen fundoplication for gastrooesophageal reflux disease may more often lead to persistent dysphagia than a Toupet fundoplication. The aim of this study was to assess the results of laparoscopic Nissen versus Toupet fundoplication in patients with reflux disease and impaired distal esophageal motility. PATIENTS AND METHODS: In 15 patients a laparoscopic Nissen and in 17 a laparoscopic Toupet fundoplication was carried out. Criteria for an impaired motility of the distal esophagus were a mean amplitude of < 30 mm Hg of swallow-induced contractions, or > 33% non-propulsive or non-transmitted contraction waves. Before surgery, heartburn, dysphagia, regurgitation and other symptoms were scored and endoscopic, manometric and 24 hour pH-metric investigations performed. Patients were reinvestigated 3 to 30 (median 15) months after Nissen and 3 to 42 (median 7) months after Toupet fundoplication. RESULTS: After Nissen as well as after Toupet fundoplication heartburn was significantly less frequent, whereas dysphagia and all other symptom-scores remained unchanged. In the 26 patients reinvestigated manometrically, the resting pressure of the lower esophageal sphincter was significantly higher following both operations and the residual sphincter pressure upon swallowing higher only after Nissen fundoplication. The amplitude of swallow-induced contractions and the percentages of non-propulsive and non-transmitted contraction waves were not significantly changed after either operation. In the 23 patients restudied pH-metrically, reflux activity was significantly reduced after both Nissen and Toupet fundoplication. CONCLUSION: In patients with reflux disease and impaired distal esophageal motility, laparoscopic Nissen and Toupet fundoplication both yielded satisfactory results and neither operation led to increased dysphagia. SN - 0009-4722 UR - https://www.unboundmedicine.com/medline/citation/11963496/[Nissen_and_Toupet_laparoscopic_fundoplication_in_patients_with_gastroesophageal_reflux_and_motility_disorders_of_the_distal_esophagus]_ L2 - https://dx.doi.org/10.1007/s00104-001-0418-9 DB - PRIME DP - Unbound Medicine ER -