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Ineffective oesophageal motility does not affect the clinical outcome of open Nissen fundoplication.
Br J Surg 2004; 91(8):1010-4BJ

Abstract

BACKGROUND

Nissen fundoplication is considered the 'gold standard' in antireflux surgery but some surgeons employ a different surgical strategy when gastro-oesophageal reflux disease (GORD) is associated with motor disorders of the oesophageal body.

METHODS

Ninety-three patients undergoing surgery for GORD were divided into two groups: 52 patients (group 1) had normal oesophageal body motility and 41 (group 2) had ineffective oesophageal motility (IOM). All patients had a short Nissen fundoplication via a laparotomy. The median follow-up was 5 years in group 1 and 6.5 years in group 2.

RESULTS

The clinical outcome was satisfactory in more than 90 per cent of the patients in both groups. Only one of ten patients with IOM and dysphagia before operation still had dysphagia after surgery. One patient in each group developed postoperative dysphagia. Six of 52 patients with normal motility and eight of 41 with IOM had persistent pathological acid reflux after surgery. Significant increases in contractile wave pressure and a decrease in the percentage of non-propagated waves were found in group 2 after fundoplication.

CONCLUSION

Patients with IOM did not have an increased rate of dysphagia after total fundoplication compared with those with normal motility, but they did have a higher rate of recurrence of endoscopic and pH-proven reflux.

Authors+Show Affiliations

Department of Surgery, Virgen de la Arrixaca University Hospital, Murcia, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15286963

Citation

Munitiz, V, et al. "Ineffective Oesophageal Motility Does Not Affect the Clinical Outcome of Open Nissen Fundoplication." The British Journal of Surgery, vol. 91, no. 8, 2004, pp. 1010-4.
Munitiz V, Ortiz A, Martinez de Haro LF, et al. Ineffective oesophageal motility does not affect the clinical outcome of open Nissen fundoplication. Br J Surg. 2004;91(8):1010-4.
Munitiz, V., Ortiz, A., Martinez de Haro, L. F., Molina, J., & Parrilla, P. (2004). Ineffective oesophageal motility does not affect the clinical outcome of open Nissen fundoplication. The British Journal of Surgery, 91(8), pp. 1010-4.
Munitiz V, et al. Ineffective Oesophageal Motility Does Not Affect the Clinical Outcome of Open Nissen Fundoplication. Br J Surg. 2004;91(8):1010-4. PubMed PMID: 15286963.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ineffective oesophageal motility does not affect the clinical outcome of open Nissen fundoplication. AU - Munitiz,V, AU - Ortiz,A, AU - Martinez de Haro,L F, AU - Molina,J, AU - Parrilla,P, PY - 2004/8/3/pubmed PY - 2004/8/25/medline PY - 2004/8/3/entrez SP - 1010 EP - 4 JF - The British journal of surgery JO - Br J Surg VL - 91 IS - 8 N2 - BACKGROUND: Nissen fundoplication is considered the 'gold standard' in antireflux surgery but some surgeons employ a different surgical strategy when gastro-oesophageal reflux disease (GORD) is associated with motor disorders of the oesophageal body. METHODS: Ninety-three patients undergoing surgery for GORD were divided into two groups: 52 patients (group 1) had normal oesophageal body motility and 41 (group 2) had ineffective oesophageal motility (IOM). All patients had a short Nissen fundoplication via a laparotomy. The median follow-up was 5 years in group 1 and 6.5 years in group 2. RESULTS: The clinical outcome was satisfactory in more than 90 per cent of the patients in both groups. Only one of ten patients with IOM and dysphagia before operation still had dysphagia after surgery. One patient in each group developed postoperative dysphagia. Six of 52 patients with normal motility and eight of 41 with IOM had persistent pathological acid reflux after surgery. Significant increases in contractile wave pressure and a decrease in the percentage of non-propagated waves were found in group 2 after fundoplication. CONCLUSION: Patients with IOM did not have an increased rate of dysphagia after total fundoplication compared with those with normal motility, but they did have a higher rate of recurrence of endoscopic and pH-proven reflux. SN - 0007-1323 UR - https://www.unboundmedicine.com/medline/citation/15286963/Ineffective_oesophageal_motility_does_not_affect_the_clinical_outcome_of_open_Nissen_fundoplication_ L2 - https://doi.org/10.1002/bjs.4597 DB - PRIME DP - Unbound Medicine ER -