Is oesophageal manometry a must before laparoscopic fundoplication? Analysis of 46 consecutive patients treated without preoperative manometry
<b>Aims:</b> To evaluate retrospectively the outcome of laparoscopic fundoplication in a cohort of patients with typical symptoms of gastroesophageal reflux disease (GERD). <b>Materials and Methods:</b> Forty-six patients with typical symptoms of GERD, from March 2001 to Nove...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2010-01-01
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| Series: | Journal of Minimal Access Surgery |
| Subjects: | |
| Online Access: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2010;volume=6;issue=3;spage=66;epage=69;aulast=Nagpal |
| _version_ | 1811202242959638528 |
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| author | Nagpal Anish Soni Harshad Haribhakti Sanjiv |
| author_facet | Nagpal Anish Soni Harshad Haribhakti Sanjiv |
| author_sort | Nagpal Anish |
| collection | DOAJ |
| description | <b>Aims:</b> To evaluate retrospectively the outcome of laparoscopic fundoplication in a cohort of patients with typical symptoms of gastroesophageal reflux disease (GERD). <b>Materials and Methods:</b> Forty-six patients with typical symptoms of GERD, from March 2001 to November 2009, were studied. The study was limited to patients with positive findings on upper GI endoscopy done by ourselves and "typical" symptoms (heartburn, regurgitation, and dysphagia) of GERD. Laparoscopic Nissen′s fundoplication was performed when clinical assessment suggested adequate oesophageal motility and length. Only 1 patient, who had negative endoscopic findings, underwent a 24-hour pH-monitoring before surgery. Outcome measures included assessment of the relief of the primary symptom responsible for surgery in the early postoperative period; the patient′s evaluation of outcome and quality of life after surgery. <b>Results:</b> Relief of the primary symptom responsible for surgery was achieved in 85% of patients at a mean follow-up of 28 months. Thirty-nine patients were asymptomatic, 2 had minor gastrointestinal symptoms not requiring medical therapy, 3 patients had gastrointestinal symptoms requiring medical therapy/ Proton Pump Inhibitors and in 2 patients the symptoms worsened after surgery. There were no deaths. Clinically significant complications occurred in 6 patients. Median hospital stay was 3 days, decreasing from 6 in the first 10 patients to 3 in the last 10 patients. <b>Conclusions:</b> Preoperative oesophageal manometry is not mandatory for laparoscopic fundoplication done in selected patients with typical symptoms of GERD and upper GI endoscopy suggestive of large hiatus hernia. |
| first_indexed | 2024-04-12T02:36:34Z |
| format | Article |
| id | doaj.art-96aa2577783b4cd39c1b670eeebd88a3 |
| institution | Directory Open Access Journal |
| issn | 0972-9941 1998-3921 |
| language | English |
| last_indexed | 2024-04-12T02:36:34Z |
| publishDate | 2010-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj.art-96aa2577783b4cd39c1b670eeebd88a32022-12-22T03:51:33ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212010-01-01636669Is oesophageal manometry a must before laparoscopic fundoplication? Analysis of 46 consecutive patients treated without preoperative manometryNagpal AnishSoni HarshadHaribhakti Sanjiv<b>Aims:</b> To evaluate retrospectively the outcome of laparoscopic fundoplication in a cohort of patients with typical symptoms of gastroesophageal reflux disease (GERD). <b>Materials and Methods:</b> Forty-six patients with typical symptoms of GERD, from March 2001 to November 2009, were studied. The study was limited to patients with positive findings on upper GI endoscopy done by ourselves and "typical" symptoms (heartburn, regurgitation, and dysphagia) of GERD. Laparoscopic Nissen′s fundoplication was performed when clinical assessment suggested adequate oesophageal motility and length. Only 1 patient, who had negative endoscopic findings, underwent a 24-hour pH-monitoring before surgery. Outcome measures included assessment of the relief of the primary symptom responsible for surgery in the early postoperative period; the patient′s evaluation of outcome and quality of life after surgery. <b>Results:</b> Relief of the primary symptom responsible for surgery was achieved in 85% of patients at a mean follow-up of 28 months. Thirty-nine patients were asymptomatic, 2 had minor gastrointestinal symptoms not requiring medical therapy, 3 patients had gastrointestinal symptoms requiring medical therapy/ Proton Pump Inhibitors and in 2 patients the symptoms worsened after surgery. There were no deaths. Clinically significant complications occurred in 6 patients. Median hospital stay was 3 days, decreasing from 6 in the first 10 patients to 3 in the last 10 patients. <b>Conclusions:</b> Preoperative oesophageal manometry is not mandatory for laparoscopic fundoplication done in selected patients with typical symptoms of GERD and upper GI endoscopy suggestive of large hiatus hernia.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2010;volume=6;issue=3;spage=66;epage=69;aulast=NagpalGastroesophageal reflux diseaselaparoscopic Nissen′s fundoplicationoesophageal manometryoutcomes |
| spellingShingle | Nagpal Anish Soni Harshad Haribhakti Sanjiv Is oesophageal manometry a must before laparoscopic fundoplication? Analysis of 46 consecutive patients treated without preoperative manometry Journal of Minimal Access Surgery Gastroesophageal reflux disease laparoscopic Nissen′s fundoplication oesophageal manometry outcomes |
| title | Is oesophageal manometry a must before laparoscopic fundoplication? Analysis of 46 consecutive patients treated without preoperative manometry |
| title_full | Is oesophageal manometry a must before laparoscopic fundoplication? Analysis of 46 consecutive patients treated without preoperative manometry |
| title_fullStr | Is oesophageal manometry a must before laparoscopic fundoplication? Analysis of 46 consecutive patients treated without preoperative manometry |
| title_full_unstemmed | Is oesophageal manometry a must before laparoscopic fundoplication? Analysis of 46 consecutive patients treated without preoperative manometry |
| title_short | Is oesophageal manometry a must before laparoscopic fundoplication? Analysis of 46 consecutive patients treated without preoperative manometry |
| title_sort | is oesophageal manometry a must before laparoscopic fundoplication analysis of 46 consecutive patients treated without preoperative manometry |
| topic | Gastroesophageal reflux disease laparoscopic Nissen′s fundoplication oesophageal manometry outcomes |
| url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2010;volume=6;issue=3;spage=66;epage=69;aulast=Nagpal |
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