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Function of the proximal stomach after partial versus complete laparoscopic fundoplication.
Am J Gastroenterol 2003; 98(2):284-90AJ

Abstract

OBJECTIVES

After antireflux surgery, more than 30% of patients develop dyspeptic symptoms such as fullness and early satiety. We have previously shown that these symptoms are related to fundoplication-induced changes in proximal gastric motor and sensory function, especially impaired postprandial relaxation. We hypothesize that impaired fundus relaxation may be more pronounced after complete versus partial fundoplication.

METHODS

Fasting and postprandial proximal gastric motor and sensory function were measured with an electronic barostat in patients after laparoscopic partial (n = 14) and complete (n = 14) fundoplication, in gastroesophageal reflux disease (GERD) patients (n = 12), and in healthy control subjects (n = 15). Gastric emptying and vagus nerve function tests were performed in all patients.

RESULTS

Minimal distending pressure (MDP) and proximal gastric compliance were not significantly different among patients after antireflux surgery, GERD patients, and healthy controls. Maximal postprandial fundus relaxation was significantly (p < 0.01) reduced in patients after partial (267 +/- 32 ml) and complete (294 +/- 34 ml) fundoplication compared with GERD patients (448 +/- 30 ml) and healthy controls (409 +/- 25 ml). Sensations of fullness were not significantly different between patients with partial and complete fundoplication. There was a significant positive correlation between the postoperative duration and the degree of postprandial fundus relaxation (r = 0.67; p < 0.001).

CONCLUSIONS

Both after complete and after partial fundoplication, proximal gastric motor function is affected, with impaired postprandial relaxation and increased sensation of fullness. These alterations are not related to the type of fundoplication but correlate significantly with the duration of the postoperative period.

Authors+Show Affiliations

Department of Gastroenterology-Hepatology, Leiden University Medical Center, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12591042

Citation

Lindeboom, M Y A., et al. "Function of the Proximal Stomach After Partial Versus Complete Laparoscopic Fundoplication." The American Journal of Gastroenterology, vol. 98, no. 2, 2003, pp. 284-90.
Lindeboom MY, Vu MK, Ringers J, et al. Function of the proximal stomach after partial versus complete laparoscopic fundoplication. Am J Gastroenterol. 2003;98(2):284-90.
Lindeboom, M. Y., Vu, M. K., Ringers, J., van Rijn, P. J., Neijenhuis, P., & Masclee, A. A. (2003). Function of the proximal stomach after partial versus complete laparoscopic fundoplication. The American Journal of Gastroenterology, 98(2), pp. 284-90.
Lindeboom MY, et al. Function of the Proximal Stomach After Partial Versus Complete Laparoscopic Fundoplication. Am J Gastroenterol. 2003;98(2):284-90. PubMed PMID: 12591042.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Function of the proximal stomach after partial versus complete laparoscopic fundoplication. AU - Lindeboom,M Y A, AU - Vu,M K, AU - Ringers,J, AU - van Rijn,P J J, AU - Neijenhuis,P, AU - Masclee,A A M, PY - 2003/2/20/pubmed PY - 2003/4/2/medline PY - 2003/2/20/entrez SP - 284 EP - 90 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 98 IS - 2 N2 - OBJECTIVES: After antireflux surgery, more than 30% of patients develop dyspeptic symptoms such as fullness and early satiety. We have previously shown that these symptoms are related to fundoplication-induced changes in proximal gastric motor and sensory function, especially impaired postprandial relaxation. We hypothesize that impaired fundus relaxation may be more pronounced after complete versus partial fundoplication. METHODS: Fasting and postprandial proximal gastric motor and sensory function were measured with an electronic barostat in patients after laparoscopic partial (n = 14) and complete (n = 14) fundoplication, in gastroesophageal reflux disease (GERD) patients (n = 12), and in healthy control subjects (n = 15). Gastric emptying and vagus nerve function tests were performed in all patients. RESULTS: Minimal distending pressure (MDP) and proximal gastric compliance were not significantly different among patients after antireflux surgery, GERD patients, and healthy controls. Maximal postprandial fundus relaxation was significantly (p < 0.01) reduced in patients after partial (267 +/- 32 ml) and complete (294 +/- 34 ml) fundoplication compared with GERD patients (448 +/- 30 ml) and healthy controls (409 +/- 25 ml). Sensations of fullness were not significantly different between patients with partial and complete fundoplication. There was a significant positive correlation between the postoperative duration and the degree of postprandial fundus relaxation (r = 0.67; p < 0.001). CONCLUSIONS: Both after complete and after partial fundoplication, proximal gastric motor function is affected, with impaired postprandial relaxation and increased sensation of fullness. These alterations are not related to the type of fundoplication but correlate significantly with the duration of the postoperative period. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/12591042/Function_of_the_proximal_stomach_after_partial_versus_complete_laparoscopic_fundoplication_ L2 - http://Insights.ovid.com/pubmed?pmid=12591042 DB - PRIME DP - Unbound Medicine ER -