Complications of surgery for gastroesophageal reflux

Skinner, David B.

doi:10.1007/bf01565918

Cited by 46 publications

(17 citation statements)

References 16 publications

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“…Skinner reported increased numbers of tertiary contractions in the distal esophagus in patients with dysphagia occurring after a Nissen procedure [16]. In our study no significant motility disturbances, not even during meals, were found to explain dysphagia.…”

Section: Discussionmentioning

confidence: 49%

Dysphagia after nissen fundoplication

et al. 1991

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Nissen fundoplication is a commonly used antireflux operation. After this operation symptoms such as dysphagia, inability to belch and vomit, and gas bloating are frequently reported in the literature. In 32 patients who underwent Nissen fundoplication 3.5-18 years ago, postprocedure dysphagia was studied using conventional manometry and 24 h ambulatory pressure and pH recording. Our study indicates that dysphagia tends to decrease after surgery. Neither conventional nor ambulatory pressure recording revealed motor abnormalities that could be held responsible for the dysphagia. Therefore, the data do not support the concept that dysphagia is a major complication of Nissen fundoplication.

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Section: Discussionmentioning

confidence: 49%

Dysphagia after nissen fundoplication

et al. 1991

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“…The presence of a Maloney dilator within the esophageal lumen gives con fidence to the surgeon that he is not pulling the gastric fundus too tight. The 60-french dilator corresponds to the diameter of the gullet sufficient to accommodate a large bolus of food [18], and its clinical use is supported by previous experience [3]. The observation that stenting the esophagus with a standard bougie yields satisfactory pressure values after Nissen fundoplication suggests that intraoperative manometry is an unnecessary and timeconsuming procedure, since it can be effectively replaced by simple mechanical calibration.…”

Section: Discussionmentioning

confidence: 77%

Nissen Fundoplication: Intraoperative Manometry or Mechanical Calibration?

Bonavina¹,

Anselmino²,

Baessato³

et al. 1990

Dig Surg

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Intraoperative manometry was performed in 7 consecutive patients undergoing Nissen fundoplication for gastroesophageal reflux disease. The aim of the study was to assess the effectiveness of the technique of mechanical calibration of the fundoplication with a 60-french Maloney bougie. Results showed a statistically significant increase of lower esophageal sphincter pressure and length over preoperative values. The values remained stable at 1 week and 6 months after operation. No patient had postoperative dysphagia or abnormal esophageal acid exposure on 24-hour esophageal pH monitoring. We conclude that mechanical calibration of the Nissen fundoplication is very effective in constructing an adequate antirefiux barrier. Intraoperative manometry adds time to the operation, and the information gained is of little practical value.

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“…This operation is, however, associated with a number of postoperative complications, in particular with a relatively high incidence rate of dysphagia; incidence rates ranging from 5% to 43% have been reported following conventional fundoplication [8,9,10], requiring reoperation for dysphagia in up to 25% of patients [5]. A major cause of dysphagia is the creation of a 360°wrap [11,12,13,14,15,16,17,18,19]. This has led to the use of procedures entailing the creation of a partial wrap.…”

Section: Discussionmentioning

confidence: 95%