Ineffective Esophageal Motility in Patients with GERD is no Contraindication for Nissen Fundoplication.
Journal
World journal of surgery
ISSN: 1432-2323
Titre abrégé: World J Surg
Pays: United States
ID NLM: 7704052
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
pubmed:
13
10
2019
medline:
29
10
2020
entrez:
13
10
2019
Statut:
ppublish
Résumé
Patients with preoperative ineffective esophageal motility (IEM) are thought to be at increased risk for postoperative dysphagia leading to the recommendations for tailoring or avoiding anti-reflux surgery in these patients. The aim of this study was to evaluate if IEM has an influence on postoperative outcome after laparoscopic Nissen fundoplication (LNF). Seventy-two consecutive patients with IEM underwent LNF and were case-matched with 72 patients without IEM based on sex, age, BMI, HH size, total pH percentage time, total number of reflux episodes and the presence of BE. Standardized interview assessing postoperative gastrointestinal symptoms, proton pump inhibitor intake, GERD-health-related-quality-of-life (GERD-HRQL), alimentary satisfaction and patients' overall satisfaction was evaluated. Although a higher rate of preoperative dysphagia was observed in patients with IEM (29% IEM vs. 11% no IEM, p = 0.007), there was no significant difference in rates of dysphagia postoperatively (2 IEM vs. 1 no IEM, p = 0.559). Furthermore, no distinction was found in the postoperative outcome regarding symptom relief, quality of life, gas bloating syndrome, ability to belch and/or vomit or revision surgery between the two groups. Although preoperative IEM has an influence on GERD presentation, it has no effect on postoperative outcome after LNF. IEM should not be a cause for avoiding LNF, as is has been shown as the most effective and safe anti-reflux treatment.
Sections du résumé
BACKGROUND
Patients with preoperative ineffective esophageal motility (IEM) are thought to be at increased risk for postoperative dysphagia leading to the recommendations for tailoring or avoiding anti-reflux surgery in these patients. The aim of this study was to evaluate if IEM has an influence on postoperative outcome after laparoscopic Nissen fundoplication (LNF).
METHODS
Seventy-two consecutive patients with IEM underwent LNF and were case-matched with 72 patients without IEM based on sex, age, BMI, HH size, total pH percentage time, total number of reflux episodes and the presence of BE. Standardized interview assessing postoperative gastrointestinal symptoms, proton pump inhibitor intake, GERD-health-related-quality-of-life (GERD-HRQL), alimentary satisfaction and patients' overall satisfaction was evaluated.
RESULTS
Although a higher rate of preoperative dysphagia was observed in patients with IEM (29% IEM vs. 11% no IEM, p = 0.007), there was no significant difference in rates of dysphagia postoperatively (2 IEM vs. 1 no IEM, p = 0.559). Furthermore, no distinction was found in the postoperative outcome regarding symptom relief, quality of life, gas bloating syndrome, ability to belch and/or vomit or revision surgery between the two groups.
CONCLUSION
Although preoperative IEM has an influence on GERD presentation, it has no effect on postoperative outcome after LNF. IEM should not be a cause for avoiding LNF, as is has been shown as the most effective and safe anti-reflux treatment.
Identifiants
pubmed: 31605176
doi: 10.1007/s00268-019-05229-y
pii: 10.1007/s00268-019-05229-y
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
186-193Références
Neurogastroenterol Motil. 2015 Feb;27(2):160-74
pubmed: 25469569
J Gastrointest Surg. 2002 Nov-Dec;6(6):812-8
pubmed: 12504219
J Gastrointest Surg. 2014 Oct;18(10):1723-9
pubmed: 25091845
Arch Surg. 2000 Sep;135(9):1055-61; discussion 1061-2
pubmed: 10982510
Surg Laparosc Endosc Percutan Tech. 2013 Jun;23(3):281-5
pubmed: 23751993
Wideochir Inne Tech Maloinwazyjne. 2015 Sep;10(3):389-97
pubmed: 26649085
Ann Surg. 2005 Jan;241(1):185-93
pubmed: 15622007
Am Surg. 2003 Mar;69(3):219-23; discussion 223-4
pubmed: 12678478
Surg Endosc. 1997 Nov;11(11):1080-3
pubmed: 9348378
Surg Endosc. 2009 Nov;23(11):2505-8
pubmed: 19343436
J Gastrointest Surg. 2017 Mar;21(3):441-445
pubmed: 27834011
Ann Surg. 1986 Jul;204(1):9-20
pubmed: 3729589
Gut. 2014 Jun;63(6):871-80
pubmed: 23853213
Surg Endosc. 2019 Apr;33(4):1196-1205
pubmed: 30171395
Aliment Pharmacol Ther. 2016 Jun;43(11):1124-31
pubmed: 27060607
Int J Surg. 2015 Nov;23(Pt A):35-40
pubmed: 26360740
Br J Surg. 2008 Jan;95(1):57-63
pubmed: 18076018
Surg Endosc. 2008 Jan;22(1):21-30
pubmed: 18027055
J Gastrointest Surg. 2002 Jan-Feb;6(1):22-7; discussion 27-8
pubmed: 11986014
World J Surg. 2017 Aug;41(8):2046-2052
pubmed: 28258450
Arch Surg. 2001 Feb;136(2):180-4
pubmed: 11177138
JAMA. 2011 May 18;305(19):1969-77
pubmed: 21586712
Am J Surg. 2002 Feb;183(2):110-6
pubmed: 11918872
J Thorac Cardiovasc Surg. 1995 Jul;110(1):141-6; discussion 146-7
pubmed: 7609537
J Obes. 2017;2017:7589408
pubmed: 28584666
Surg Endosc. 2018 May;32(5):2365-2372
pubmed: 29234939
Am J Gastroenterol. 1995 Jan;90(1):35-8
pubmed: 7801945
Surg Endosc. 2010 Feb;24(2):390-4
pubmed: 19551431
World J Gastrointest Surg. 2016 Jan 27;8(1):77-83
pubmed: 26843915
Am J Surg. 1995 Dec;170(6):614-7; discussion 617-8
pubmed: 7492012
Surg Endosc. 2007 Feb;21(2):285-8
pubmed: 17122978
Gastrointest Endosc. 1995 Mar;41(3):189-95
pubmed: 7789675
J Am Coll Surg. 2015 Jul;221(1):123-8
pubmed: 26095560
Gastroenterology. 2001 Jul;121(1):5-14
pubmed: 11438489
Surg Endosc. 1996 Oct;10(10):979-82
pubmed: 8864089
Surg Endosc. 2006 Nov;20(11):1662-70
pubmed: 17024541
J Am Coll Surg. 2004 Jun;198(6):863-9; discussion 869-70
pubmed: 15194064
Gastroenterology. 2018 Jan;154(2):302-318
pubmed: 28827081
Saudi J Gastroenterol. 2005 May;11(2):73-84
pubmed: 19861849