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https://hdl.handle.net/2440/52140
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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 1873-4626 |
Statement of Responsibility: | 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 www.springerlink.com |
DOI: | 10.1007/s11605-008-0486-y |
Published version: | http://dx.doi.org/10.1007/s11605-008-0486-y |
Appears in Collections: | Aurora harvest 5 Surgery publications |
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