Z Gastroenterol 2004; 42 - 171
DOI: 10.1055/s-2004-827072

Effect of laparoscopic antireflux surgery on esophageal motility in patients with GERD

S Undi 1, A Illés 1, G Sütő 1, G Varga 2, ÖP Horváth 2, Á Király 1
  • 1Third Dept. of Medicine
  • 2Dept. of Surgery, University of Pécs Medical Centre, 1st Dept. of Medicine, University of Pécs

Background: Nissen-Rosetti fundoplication was developed to treat therapy resistant reflux disease. The aim of this study was to evaluate the long-term effect of laparoscopic Nissen fundoplication on esophageal motility.

Methods: Esophageal manometry was done preoperatively, six month and five year after the operation at 10 patients with GERD. Peristaltic wave amplitude, propagation velocity, incidence of peristaltic dysfunction, LES length, tone and relaxation were analyzed.

Results:

Preoperative

6 month control

5 year control

LES pressure

11,37±5,16

22,15±6,11

15,61±6,38

LES relaxation

92,9±5%

78,3±9%

76,5±4%

Perist. ampl 5cm

90,66±11

100,41±12

87,71±9

above LES: 10cm (mmHg)

75,24±9

80,83±8

47,54±6

15cm

35,59±5

64,12±6

46,65±5

20cm

50,04±7

53,48±5

37,49±5

interrupted seq.

18/100 swallow

12/100 swallow

14/100 swallow

motility disorder

7/10 patient

5/10 patient

5/10 patient

Conclusions: Antireflux procedure induces mild improvement in the LES and esophageal body motility function. Thus the mechanism of action of total fundic wrap seems to be the prevention of transient LES relaxation-induced acid reflux.

This study was supported by the grant OTKA F 034433 and ETT 550/2003.