Esophageal manometry and clinical outcome after laparoscopic Nissen fundoplication.

Esophageal manometry and clinical outcome after laparoscopic Nissen fundoplication. Research Abstract Details 

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Esophageal manometry and clinical outcome after laparoscopic Nissen fundoplication. Abstract Text:

Huiqi Yang,David I Watson,Jamie Kelly,Carolyn J Lally,Jennifer C Myers,Glyn G Jamieson,Huiqi Yang,David I Watson,Jamie Kelly,Carolyn J Lally,Jennifer C Myers,Glyn G Jamieson,

INTRODUCTION: The outcome after laparoscopic Nissen fundoplication can be assessed by either clinical symptoms or objective tests. Outcomes from objective tests are often held in higher regard than clinical data when determining the merits, or otherwise, of various antireflux surgery procedures. In this study, we sought to determine whether there is a relationship between postoperative symptoms and parameters measured by esophageal manometry to determine whether early postoperative esophageal manometry is a useful investigation for the routine assessment of post fundoplication outcome. METHODS: One hundred and forty-three patients who had undergone a laparoscopic Nissen fundoplication, clinical follow-up at 3 months and 5 years after surgery, and esophageal manometry at 3 months after fundoplication as part of routine follow-up in 1 of 5 clinical trials were studied. Nineteen of these patients also underwent manometry 5 years after fundoplication. Postoperative symptoms were prospectively determined by applying a standardized questionnaire, which assessed dysphagia, heartburn, bloat symptoms, and overall satisfaction using analog scales. Patients were classified into different groups according to the analog scores for clinical symptoms. Correlations between clinical and postoperative manometry outcomes were sought. RESULTS: No significant associations were found between parameters measured by esophageal manometry (lower esophageal sphincter resting and residual relaxation pressures, peristaltic amplitude and normal peristaltic propagation) and clinical parameters (dysphagia, heartburn, bloating, and overall satisfaction) for all time points -- 3 months postoperative manometry vs symptoms at 3 months and 5 years, 5 years postoperative manometry vs symptoms at 5 years, except for a weak (r = -0.17, p = 0.042) correlation between the percentage of successfully propagated swallows at 3 months and dysphagia for solids at 5 years. CONCLUSION: Postoperative esophageal manometry parameters at 3 months and 5 years after surgery were not associated with any clinically important differences in the postoperative symptoms of heartburn, dysphagia, bloat or with overall satisfaction with the surgical outcome. The routine use of esophageal manometry to assess the outcome after Nissen fundoplication does not predict clinical outcome.

Esophageal manometry and clinical outcome after laparoscopic Nissen fundoplication. Publishing Authors By Initials

H Yang,DI Watson,J Kelly,CJ Lally,JC Myers,GG Jamieson,H Yang,DI Watson,J Kelly,CJ Lally,JC Myers,GG Jamieson,

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Esophageal manometry and clinical outcome after laparoscopic Nissen fundoplication. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of gastrointestinal surgery : official jou

VOLUME: 11

Page Numbers: 1126-33

Journal Abbreviation: J. Gastrointest. Surg.

ISSN: 1091-255X

DAY: 22

MONTH: Sep

YEAR: 2007

Esophageal manometry and clinical outcome after laparoscopic Nissen fundoplication. Information

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LANGUAGE: eng

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Grant and Affiliation Information for Esophageal manometry and clinical outcome after laparoscopic Nissen fundoplication.

AFFILIATION: Department of Surgery, Flinders University, Room 3D211, Flinders Medical Centre, Bedford Park, Adelaide, SA, Australia.

Country: United States

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MEDLINETA: J Gastrointest Surg

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