Selective Use of Esophageal Manometry and 24-Hour PH Monitoring Before Laparoscopic Fundoplication

Frantzides, Constantine T.; Carlson, Mark A.; Madan, Atul K.; Stewart, Edward T.; Smith, Claire

doi:10.1016/s1072-7515(03)00591-x

Cited by 37 publications

(15 citation statements)

References 19 publications

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“…10,14 The mean age was 42 (range, 23-78). The primary procedure either was a laparoscopic Nissen (n ϭ 61) or laparoscopic Toupet (n ϭ 7) fundoplication.…”

Section: Resultsmentioning

confidence: 99%

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Laparoscopic Revision of Failed Fundoplication and Hiatal Herniorraphy

Frantzides

Madan

Carlson

et al. 2009

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Objective: The aim of this study was to evaluate the mechanisms of failure after laparoscopic fundoplication and the results of revision laparoscopic fundoplication. Background: Laparoscopic Nissen fundoplication has become the most commonly performed antireflux procedure for the treatment of gastroesophageal reflux disease, with success rates from 90 to 95%. Persistent or new symptoms often warrant endoscopic and radiographic studies to find the cause of surgical failure. In experienced hands, reoperative antireflux surgery can be done laparoscopically. We performed a retrospective analysis of all laparoscopic revision of failed fundoplications done by the principle author and the respective fellow within the laparoscopic fellowship from 1992 to 2006. Methods: A review was performed on patients who underwent laparoscopic revision of a failed primary laparoscopic fundoplication. Results: Laparoscopic revision of failed fundoplication was performed on 68 patients between 1992 and 2006. The success rate of the laparoscopic redo Nissen fundoplication was 86%. Symptoms prior to the revision procedure included heartburn (69%), dysphagia (8.8%), or both (11.7%). Preoperative evaluation revealed esophagitis in 41%, hiatal hernia with esophagitis in 36%, hiatal hernia without esophagitis in 7.3%, stenosis in 11.74%, and dysmotility in 2.4%. The main laparoscopic revisions included fundoplication alone (41%) or fundoplication with hiatal hernia repair (50%). Four gastric perforations occurred; these were repaired primarily without further incident. An open conversion was performed in 1 patient. Length of stay was 2.5 Ϯ 1.0 days. Mean follow-up was 22 months (range, 6-42), during which failure of the redo procedure was noted in 9 patients (13.23%). Conclusion: Laparoscopic redo antireflux surgery, performed in a laparoscopic fellowship program, produces excellent results that approach the success rates of primary operations. 135

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“…10,14 The mean age was 42 (range, 23-78). The primary procedure either was a laparoscopic Nissen (n ϭ 61) or laparoscopic Toupet (n ϭ 7) fundoplication.…”

Section: Resultsmentioning

confidence: 99%

“…Manometry was performed selectively in patients with symptoms of dysphagia/odynophagia and/or with evidence of abnormal motility on UGI. 10 Our technique for both primary and reoperative laparoscopic Nissen fundoplication with hiatal herniorraphy has been described. 9,11,12 Briefly, the abdomen was entered with an optical trocar.…”

Section: Methodsmentioning

confidence: 99%

Laparoscopic Revision of Failed Fundoplication and Hiatal Herniorraphy

Frantzides

Madan

Carlson

et al. 2009

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…Further diagnostic testing was considered only when there were symptoms suggesting complicated disease: dysphagia, odinophagia, bleeding, and weight loss. This practice is corroborated by a study of Frantzides et al [8], which found that the routine use of manometry and pH testing was not essential in the preoperative evaluation of patients undergoing fundoplication for GERD. The long-term success rates of open antireflux surgery for GERD are reported to be 85% to 95%.…”

Section: Discussionmentioning

confidence: 80%

Histologic and clinical outcome after laparoscopic Nissen fundoplication for gastroesophageal reflux disease and Barrett’s esophagus

et al. 2005

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“…Stationary manometry [18][19][20] of the esophagus was performed before and after the operation using a lowcompliance pneumohydraulic system (Dyno 2000 Menfis Biomedica, Bologna, Italy). Medications exerting a possible effect on esophageal motility were discontinued 5 days before examination.…”

Section: Methodsmentioning

confidence: 99%