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Type: Journal article
Title: Concurrent fluoroscopy and manometry reveal differences in laparoscopic nissen and anterior fundoplication
Author: Anderson, J.
Myers, J.
Watson, D.
Gabb, M.
Mathew, G.
Jamieson, G.
Citation: Digestive Diseases and Sciences, 1998; 43(4):847-853
Issue Date: 1998
ISSN: 0163-2116
Abstract: A prospective double-blind randomized trial wasinitiated to examine two types of laparoscopicfundoplication (Nissen and anterior). Thirty-twopatients with proven gastroesophageal reflux diseasepresenting for primary laparoscopic antireflux surgerywere randomized to undergo either Nissen fundoplication(N = 13) or anterior hemifundoplication (N = 19).Postoperative fluoroscopic and manometric examinationwas carried out concomitantly. Nissenfundoplication resulted in significantly greaterelevation of resting (33.5 vs 23 mm Hg) and residuallower esophageal sphincter pressures (17 vs 6.5 mm Hg)and lower esophageal ramp pressure (26 vs 20.5 mm Hg) than theanterior partial fundoplication. A smallerradiologically measured sphincter opening diameter wasseen following Nissen fundoplication (9 mm) comparedwith anterior fundoplication (12 mm). Lower esophageal ramppressure correlated weakly (r = 0.37, P = 0.04) withpostoperative dysphagia. It is concluded that the typeof fundoplication performed significantly influences postoperative manometric and video bariumradiology outcomes. The clinical relevance of thisrequires further investigation.
Keywords: Esophagogastric Junction; Humans; Gastroesophageal Reflux; Barium Sulfate; Contrast Media; Fluoroscopy; Laparoscopy; Fundoplication; Postoperative Period; Prospective Studies; Double-Blind Method; Manometry; Deglutition; Pressure; Videotape Recording; Middle Aged; Female; Male
RMID: 0030004645
DOI: 10.1023/A:1018886602752
Appears in Collections:Surgery publications

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