Skip to main content
Log in

Effects of laparoscopic Nissen fundoplication on esophageal motility

Long-term results

  • Published:
Surgical Endoscopy And Other Interventional Techniques Aims and scope Submit manuscript

Abstract

Background

This study aimed to evaluate the long-term impact of laparoscopic Nissen fundoplication on esophageal motility in patients with preoperative esophageal dysmotility.

Methods

This study prospectively followed 580 patients who underwent laparoscopic Nissen fundoplication between 1992 and 1999. Esophageal manometry, 24-h pH monitoring, and symptom score assessment were performed before surgery, then 6 months, 2 years, and 5 years after surgery. Preoperatively, 533 of the patients (93.5%) had normal esophageal contractile pressure (group 1), whereas 38 of the patients (6.5%) had reduced contractile pressure (<30 mmHg) (group 2).

Results

Esophageal contractile pressures increased significantly in the patients with low preoperative values, whereas it remained unchanged in the patients with normal preoperative contractile pressures. Both groups reported a significant reduction in the dysphagia symptom score after surgery.

Conclusion

Nissen fundoplication produces a significant long-lasting increase in esophageal contractile pressures in patients with preoperative esophageal dysmotility (i.e., contractile pressure lower than 30 mmHg). Preoperative esophageal dysmotility is therefore not a contraindication to laparoscopic Nissen fundoplication.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Allen CJ, Parameswaram K, Belda J, Anvari M (2000) Reproducibility, validity, and responsiveness of a disease-specific symptom questionnaire for gastroesophageal reflux disease. Dis Esophagus13: 265–270

    Article  CAS  PubMed  Google Scholar 

  2. Anvari M, Allen CJ (2003) Five-year comprehensive outcomes evaluation in 181 patients after laparoscopic Nissen fundoplication. J Am Coll Surg 196: 51–57

    PubMed  Google Scholar 

  3. Beckingham IJ, Cariem AK, Bornman PC, Callanan MD, Louw JA (1998) Oesophageal dysmotility is not associated with poor outcome after laparoscopic Nissen fundoplication. Br J Surg 85: 1290–1293

    CAS  PubMed  Google Scholar 

  4. Bessell JR, Finch R, Gotley DC, Smithers BM, Nathanson L, Menzies B (2000) Chronic dysphagia following laparoscopic fundoplication. Br J Surg 87: 1341–1345

    Article  CAS  PubMed  Google Scholar 

  5. Chrysos E, Tsiassouis J, O Zoras, E Athanasakis, A Mantides, A Katsamouris, Xynos E (2003) Laparoscopic surgery for gastroesophageal reflux disease patients with impaired esophageal peristalsis: total or partial fundoplication? J Am Coll Surg 197: 8–15

    Article  PubMed  Google Scholar 

  6. Dallemagne B, Weerts JM, Jehaes C, Markiewicz S, Lombard R (1991) Laparoscopic Nissen fundoplication: preliminary report. Surg Laparosc Endosc 1: 138–143

    CAS  PubMed  Google Scholar 

  7. Fibbe C, Layer P, Keller J, Strate U, Emmermann A, Zornig C (2001) Esophageal motility in reflux disease before and after fundoplication: a prospective, randomized, clinical, and manometric study. Gastroenterology 121: 5–14

    Article  CAS  PubMed  Google Scholar 

  8. Freys SM, Fuchs KH, Heimbucher J, Thiede A (1997) Tailored augmentation of the lower esophageal sphincter in experimental antireflux operations. Surg Endosc 11: 1183–1188

    Article  CAS  PubMed  Google Scholar 

  9. Granderath F, Kamolz T, Schweiger U, Pasiut M, Wykypiel H, Pointer R (2002) Quality of life and symptomatic outcome three to five years after laparoscopic Toupet fundoplication in gastroesophageal reflux disease patients with impaired esophageal motility. Am J Surg 183: 110–116

    Article  PubMed  Google Scholar 

  10. Hunter J (2004) Invited commentary. J Am Coll Surg 198: 869

    Article  Google Scholar 

  11. Lund RJ, Wetcher GJ, Raiser F, Glaser K, Perdikis G, Gadenstatter M, Katada N, Filipi CJ, Hinder RA (1997) Laparoscopic Toupet fundoplication for gastroesophageal reflux disease with poor esophageal body motility. J Gastrointest Surg 1: 301–308

    Article  PubMed  Google Scholar 

  12. Mathew G, Watson DI, Myers JC, Holloway RH, Jamieson GG (1997) Oesophageal motility before and after laparoscopic Nissen fundoplication. Br J Surg 84: 1465–1469

    Article  CAS  PubMed  Google Scholar 

  13. Nissen R (1956) Eine einfache Operation zur Beeinflussung der Refluxoesophagitis. Schweiz Med Wochenschr 86: 590–592

    CAS  PubMed  Google Scholar 

  14. Watson DI, Pike GK, Baigrie RJ, Mathew G, Devitt PG, Britten-Jones R, Jamieson GG (1997) Prospective double-blind randomised trial of laparoscopic Nissen fundoplication with division and without division of short gastric vessels. Ann Surg 226: 642–652

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Anvari.

Additional information

Presented at the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) meeting, Fort Lauderdale, FL, 13–16 April 2005

Rights and permissions

Reprints and permissions

About this article

Cite this article

Biertho, L., Sebajang, H. & Anvari, M. Effects of laparoscopic Nissen fundoplication on esophageal motility. Surg Endosc 20, 619–623 (2006). https://doi.org/10.1007/s00464-005-0256-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-005-0256-9

Keywords

Navigation