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Preoperative Lower Esophageal Sphincter Manometry Data Neither Impact Manifestations of GERD nor Outcome After Laparoscopic Nissen Fundoplication

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

Experience with laparoscopic antireflux surgery (LARS) in patients with gastroesophageal reflux disease (GERD) and manometrically intact lower esophageal sphincter (LES) is limited. The disease pattern may be different and LARS may fail to control reflux or result in higher rates of dysphagia. This is the first study investigating the impact of preoperative LES manometry data not only on manifestations of GERD and subjective outcome alone but also on objective outcomes 1 year after LARS.

Methods

Three hundred fifty-one GERD patients underwent LARS and had subjective symptom and quality of life assessment, upper gastrointestinal endoscopy, barium swallow esophagogram, 24-h esophageal pH monitoring, and manometry pre- and 1 year postoperatively. Patients were divided into those with a preoperatively intact versus defective LES based on intraabdominal length and resting pressure. Baseline and 1-year postoperative follow-up data were compared.

Results

Preoperative manifestations of GERD were similar in each group. Postoperatively, all symptoms except flatulence, quality of life scores, and objective manifestations improved significantly in each group.

Conclusions

The preoperative manometric character of the LES neither impacts the manifestations of GERD nor subjective and objective outcomes after LARS. Patients with GERD and manometrically intact LES have no higher risk for postoperative dysphagia.

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Authors and Affiliations

  1. Department of Surgery, General Hospital of Krems, Krems, Austria

    Otto Riedl, Michael Gadenstätter, Wolfgang Lechner, Gerhard Schwab, Martina Marker & Ruxandra Ciovica

  2. Pfarrplatz 4, 3484, Grafenwoerth, Austria

    Otto Riedl

  3. Karl Landsteiner Institute, St. Poelten, Austria

    Michael Gadenstätter

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  1. Otto Riedl
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Correspondence to Otto Riedl.

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Riedl, O., Gadenstätter, M., Lechner, W. et al. Preoperative Lower Esophageal Sphincter Manometry Data Neither Impact Manifestations of GERD nor Outcome After Laparoscopic Nissen Fundoplication. J Gastrointest Surg 13, 1189–1197 (2009). https://doi.org/10.1007/s11605-009-0890-y

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