Chronic dysphagia following laparoscopic fundoplication

Bessell, J., Finch, R., Gotley, D. C., Smithers, B. M., Nathanson, L. K. and Menzies, B. L. (2000) Chronic dysphagia following laparoscopic fundoplication. British Journal of Surgery, 87 10: 1341-1345. doi:10.1046/j.1365-2168.2000.01634.x

Author Bessell, J.
Finch, R.
Gotley, D. C.
Smithers, B. M.
Nathanson, L. K.
Menzies, B. L.
Title Chronic dysphagia following laparoscopic fundoplication
Journal name British Journal of Surgery   Check publisher's open access policy
ISSN 0007-1323
Publication date 2000
Sub-type Article (original research)
DOI 10.1046/j.1365-2168.2000.01634.x
Volume 87
Issue 10
Start page 1341
End page 1345
Total pages 105
Place of publication UK
Publisher John Wiley & Sons
Collection year 2000
Language eng
Subject C1
321099 Clinical Sciences not elsewhere classified
730109 Surgical methods and procedures
Formatted abstract
Many surgeons practise tailored laparoscopic antireflux surgery in an attempt to prevent postoperative dysphagia. The aim of this study was to determine the effect of 360° fundoplication (Nissen) or 270° fundoplication (Toupet), and the influence of abnormal oesophageal peristalsis, upon postoperative dysphagia.

This was a cohort study from three tertiary referral centres, using dysphagia before laparoscopic fundoplication and 1 year after operation as the main outcome variable. Preoperative oesophageal manometry was performed on all patients.

Some 761 patients underwent Nissen and 85 underwent Toupet fundoplication. Only 2 per cent reported severe postoperative dysphagia. There was a significant selection bias towards the Toupet operation for patients with abnormal oesophageal motility (P < 0·001). For patients whose oesophageal manometric findings were normal there was a significant improvement in dysphagia after Nissen fundoplication (P = 0·02), and no significant change following Toupet fundoplication. There was no significant change in the rate of dysphagia following either method of fundoplication amongst other subgroups in which oesophageal manometry was stratified as non-specific motor disorder, low-amplitude peristalsis, or aperistalsis.

A tailored approach to the degree of fundoplication is unnecessary as patients with dysmotility suffer no more dysphagia after full laparoscopic Nissen fundoplication than those who have a partial Toupet wrap. © 2000 British Journal of Surgery Society Ltd
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 31 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 10 Jun 2008, 13:15:30 EST