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Type: Journal article
Title: Esophageal pH profile following laparoscopic total fundoplication compared to anterior fundoplication
Author: Wong, A.
Myers, J.
Jamieson, G.
Citation: Journal of Gastrointestinal Surgery, 2008; 12(8):1341-1345
Publisher: Elsevier Svience Inc
Issue Date: 2008
ISSN: 1091-255X
Statement of
Andrew S. Y. Wong, Jennifer C. Myers and Glyn G. Jamieson
Abstract: In Barrett’s esophagus, total abolition of reflux may give maximum protection against the development of malignancy. To determine whether laparoscopic anterior fundoplication gives the same degree of antireflux control as a total fundoplication, we analyzed a prospectively followed cohort of patients from randomized controlled trials of laparoscopic antireflux surgery. There were 167 patients who returned for routine esophageal pH studies within 6 months of surgery (123 laparoscopic total fundoplications and 44 anterior fundoplications). There was no difference in percentage time pH <4 between fundoplication groups, but the total number of reflux episodes was significantly different (total fundoplication, four reflux events vs. partial fundoplication, six reflux events; p = 0.03). It is difficult to believe that this difference is either biologically or clinically important. In patients with a second esophageal pH study more than 5 years later, both the percentage time pH <4 (0.1% total fundoplication vs. 2.7% partial fundoplication; p = 0.004) and total number of reflux episodes (three total fundoplication vs. 24 partial fundoplication; p = 0.002) were significantly different. However, the postoperative esophageal acid exposure was within the normal range for both total and partial fundoplication, so whether the statistical difference is clinically important, remains a moot point.
Keywords: Laparoscopic fundoplication; Gastro-esophageal reflux; Esophageal pH monitoring; Randomized controlled trial
Description: The original publication can be found at
RMID: 0020081788
DOI: 10.1007/s11605-008-0486-y
Appears in Collections:Surgery publications

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