Influence of wrap length on the effectiveness of Nissen and Toupet fundoplications: 5-year results of prospective, randomized study

Abstract

Nissen and Toupet fundoplication achieved sufficient control of reflux with success rate of 85 % at 5-year follow-up. There were no significant differences in the postoperative dysphagia, esophagitis, and bloating rates. However, the distribution of treatment failures leads us to conclude that 1.5-cm wrap length is insufficient in cases of posterior partial fundoplication.

Persistent dysphagia is a rare problem after laparoscopic Nissen fundoplication

“…Studies have shown that not only the type of fundoplication, but also the length of the wrap effects the prevalence of PD. Thus, the policy of a thin Nissen sleeve, measuring not longer than 1.5–2 cm has been established [10, 26]. …”

Routine versus selective contrast imaging to identify the need for early re-intervention following laparoscopic fundoplication: A retrospective cohort study

“…These include an inadequate length of intraabdominal oesophagus due to esophageal shortening or inadequate hiatal dissection [16] and incomplete or insufficient excision of a hiatus hernial sac [17]. Furthermore, the anti-reflux wrap may be shorter than the recommended 2 cm length resulting in suboptimal inhibition of reflux or too long resulting in dysphagia [18].…”

The Long-Term Results of Endosurgical Treatment of Paresisophageal Hernias

“…Помимо рецидива грыжи стойкая послеопера-ционная дисфагия является самым распространен-ным осложнением оперативного лечения ГПОД, частота которого составляет по данным различных авторов от 3 до 30 % [9].…”

“…По данным некоторых авторов использование сетчатого импланта для пластики пищеводного от-верстия диафрагмы увеличивает риск развития стойкой дисфагии в отдаленном послеоперацион-ном периоде [9].…”

“…Креатив-ная хирургия и онкология. 2017;7(4): [4][5][6][7][8][9][10] Introduction. There is a perception that the use of a mesh for surgical treatment of paraesophageal hernias significantly reduces the number of recurrences.…”