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Type: Journal article
Title: Preoperative gastric emptying and patterns of reflux as predictors of outcome after laparoscopic fundoplication
Author: Wayman, J.
Myers, J.
Jamieson, G.
Citation: British Journal of Surgery, 2007; 94(5):592-598
Publisher: John Wiley & Sons Ltd
Issue Date: 2007
ISSN: 0007-1323
Statement of
J. Wayman, J.C. Myers and G.G. Jamieson
Abstract: BACKGROUND: Some studies have suggested that patients with predominantly upright reflux have a poor outcome after laparoscopic antireflux surgery. It has been proposed that this might be related to gastric emptying. The aim of this study was to evaluate the relationship between preoperative upright reflux pattern, gastric emptying rate and outcome after laparoscopic fundoplication. METHODS: Patients presenting for antireflux surgery underwent 24-h ambulatory pH testing and dual-isotope radionuclide gastric emptying studies. Reflux pattern was determined by the acid exposure in the distal oesophagus (percentage of time at pH < 4) during supine and upright posture. Outcome after fundoplication was assessed by a standardized postal questionnaire administered at 3 months, and 1, 2 and 5 years after surgery. RESULTS: Of 372 patients identified from a prospectively maintained database, 109 had upright reflux, 57 supine reflux and 206 bipositional reflux. Overall patient satisfaction was not influenced by reflux pattern at any time after surgery. Delayed gastric emptying was documented in 31.0 per cent of patients, but there was no relationship with reflux pattern. CONCLUSION: Patients with upright reflux did not have a less favourable outcome after fundoplication. Categorizing patients according to reflux pattern is of no value in predicting outcome or selecting patients for surgery.
Keywords: Humans; Gastroesophageal Reflux; Postoperative Complications; Laparoscopy; Treatment Outcome; Preoperative Care; Fundoplication; Prospective Studies; Predictive Value of Tests; Gastric Emptying; Adult; Middle Aged; Patient Satisfaction; Female; Male
Description: Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd
RMID: 0020070682
DOI: 10.1002/bjs.5465
Appears in Collections:Surgery publications

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