Results of Laparoscopic Fundoplication Where Atypical Symptoms Coexist With Oesophageal Reflux

Abstract

Laparoscopic Nissen fundoplication controlled typical reflux symptoms very well but atypical symptoms were improved in only approximately 50%. A lower satisfaction score was associated with preoperative atypical symptoms.

Surgical outcome in gastro-esophageal reflux disease patients with inadequate response to proton pump inhibitors

“…Thus, the primary reason for failure in our patient cohort was either inadequate control of regurgitation/ aspiration or the fact the symptoms were possibly due to non-acid reflux. Under these circumstances a fundoplication which augments the antireflux barrier at the lower esophageal sphincter is likely to produce significant symptom improvement, a fact confirmed by this study [7]. Our center has recently begun analysis of nonacid reflux using impedance technology, and further evaluation of poor responders is under way.…”

Clinical outcomes of atypical extra-esophageal reflux symptoms following laparoscopic antireflux surgery

“…DeMeester et al reported the presence of chronic respiratory symptoms in 70% of patients with GERD, with only a minority receiving benefit in these symptoms following antireflux surgery [20]. Similarly, Chen and Thomas reported that only half of the patients in their study had improvement of atypical symptoms [21]. Our cohort of patients was distinct in that overlapping extra-esophageal atypical symptoms were specifically targeted for analysis in patients with documented evidence of GERD on preoperative physiologic testing.…”

Preoperative symptom evaluation and esophageal acid infusion predict response to laparoscopic Nissen fundoplication in gastroesophageal reflux patients who present with cough

“…A number of studies have now been reported [8,12,27,28,30], but there is a wide range in the degree of success achieved in controlling respiratory symptoms. Indeed, reported success rates range from 58% [30] to 83% [1,11].…”