ESOPHAGEAL MOTILITY IN GASTROESOPHAGEAL REFLUX DISEASE BEFORE AND AFTER LAPAROSCOPIC NISSEN FUNDOPLICATION | ||
| The Egyptian Journal of Surgery | ||
| Volume 32, Issue 3, July 2013, Pages 193-200 PDF (130.9 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2013.366731 | ||
| Authors | ||
| Emad Hamdy* ; Mohamed El-Hemaly; Tarek Salah; Ayman El-Nakeeb; Waleed Askar; Helmy Ezzat; Magdy Haleem; Nabil Gad El-Hak | ||
| Gastroenterology Center, Mansoura University, Egypt | ||
| Abstract | ||
| Background and Aims: The aim of this study was to determine whether esophageal motor function changes after Laparoscopic Nissen Fundoplication (LNF) and whether esophageal dysmotility affects symptoms of Gastro-Esophageal Reflux Disease (GERD) or clinical outcome postoperatively. Methods: This study included 200 patients with GERD who were operated upon by LNF in El-Mansoura Gastroenterology Surgical Center in the period between January, 2002 and March, 2008. All patients were subjected preoperatively to thorough clinical evaluation, upper endoscopy, barium study, esophageal manometry and 24-hour pH metry. Patients were stratified according to presence (24 cases) or absence of esophageal dysmotility (176 cases) and all underwent LNF. At postoperative follow-up (early within 6 months and late after 5 years from the date of surgery), preoperative tests were repeated, Results: Mean Lower Esophageal Sphincter (LES) pressure improved from 10.9 mmHg to 22.3 mmHg (p<.001), while, the amplitude of peristaltic waves in different parts of the esophagus showed no significant change and the results were nearly similar to the preoperative values (p>.05). Esophageal dysmotility had no effect on the severity of reflux or the clinical outcome postoperatively (p>.05). All cases with preoperative esophageal dysmotility had postoperative normal body motility (p<.001). Conclusions: The significant increase in basal LES pressure after LNF in patients with symptomatic GERD appears the most dramatic effect of fundoplication on esophageal physiology and should explain the efficacy of the surgical antireflux procedure. Esophageal dysmotility (1) does not reflect more severe disease; (2) does not affect postoperative clinical outcome; and (3) may improve with fundoplication. | ||
| Keywords | ||
| Esophageal Motility; GERD; Laparoscopic Nissen Fundoplication | ||
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