Influence of wrap length on the effectiveness of Nissen and Toupet fundoplication: a prospective randomized study

Mickevičius, Antanas; Endzinas, Žilvinas; Kiudelis, Mindaugas; Jonaitis, Laimas Virginijus; Kupčinskas, Limas; Maleckas, Almantas; Pundzius, Juozas

doi:10.1007/s00464-008-9852-9

Cited by 58 publications

(45 citation statements)

References 28 publications

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“…Отсутствие различий в величине давления НПС в группах «Shortfloppy Nissen» и «Nissen-Rossetti» соответствует данным зару-бежных авторов об отсутствии влияния длины фун-допликационной манжеты на тонус НПС [3,14,15].…”

Section: Discussionunclassified

“…В нашем исследовании пересе-чение коротких желудочных сосудов не повлияло на количество пациентов с дисфагией в сроки от 6 до 60 мес после операции, что соответствует зарубеж-ным исследованиям [14].…”

Section: Discussionunclassified

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Pressure of the lower esophageal sphincter as a prognostic test result of antireflux surgery

Тимербулатов¹,

Senderovich²,

Гришина³

et al. 2015

Endosk. khir.

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Section: Discussionunclassified

Pressure of the lower esophageal sphincter as a prognostic test result of antireflux surgery

Тимербулатов¹,

Senderovich²,

Гришина³

et al. 2015

Endosk. khir.

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“…The primary determinant of segment length may be the posterior cover of the stomach, not anterior stitches (18). One randomized study compared short and long fundic wrap in Nissen and Toupet fundoplication (19). They were unable to confirm the influence of wrap length on treatment failure of Nissen fundoplication.…”

Section: Discussionmentioning

confidence: 99%

The effect of narrowed segment length on the degree of early postoperative dysphagia in laparoscopic Nissen fundoplication

Altun

Akyüz²,

Banlı³

et al. 2012

Turk J Gastroenterol

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“…[37][38][39][40][41][42] The recurrence rate of erosive esophagitis resulting from failure of antireflux operation ranges from 3% to 16%, most of them caused by a misperformed surgical procedure with a high proportion of positive acid reflux tests after the operation. 23 Mickevicius et al 43 suggests that a wrap length is important in fundoplication in order to avoid postsurgical failures. These findings in some way agree with our results in that a good valve assessed early after surgery could ensure successful late results in agreement with Jobe's study.…”

Section: Discussionmentioning

confidence: 99%

Radiologic and Endoscopic Characteristics of Laparoscopic Antireflux Wrap: Correlation With Outcome

Braghetto

Korn

Csendes

et al. 2012

International Surgery

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After antireflux surgery for gastroesophageal reflux disease, 10% to 15% of patients may have unsuccessful results as a result of abnormal restoration of the esophagogastric junction. The purpose of this study was to evaluate the postoperative endoscopic and radiologic characteristics of the antireflux barrier and their correlation with the postoperative results. After surgery, endoscopic and radiologic features of the antireflux wrap were evaluated in 120 consecutive patients. Jobe's classification of the postoperative valve was used for the definition of a ''normal'' or ''defective'' wrap. Patients were evaluated 3 to 5 years later in order to determine the clinical and objective failed fundoplication. A ''normal'' antireflux wrap was associated with successful results in 81.7% of the patients. On the contrary, defective radiologic or endoscopic antireflux wrap was observed in 19% of cases. Among these patients, hypotensive lower esophageal sphincter was observed in 50% to 65% of patients, abnormal 24-hour pH monitoring in 91%, and recurrent postoperative erosive esophagitis in 50% of patients, respectively (P , 0.001). ''Defective'' antireflux fundoplication is associated with recurrent reflux symptoms, presence of endoscopic esophagitis, hypotensive lower esophageal sphincter, and abnormal acid reflux.Key words: Antireflux surgery -Postoperative failures -Defective fundoplication P atients with gastroesophageal reflux disease (GERD) have anatomic defects of the esophagogastric junction (EGJ) as dilatation of the cardia and/or presence of hiatal hernia. [1][2][3][4] These defects have been associated with incompetence of the lower esophageal sphincter (LES) and pathologic acid reflux. The aim of antireflux surgery is to create an antireflux barrier by increasing the competence of the LES and to avoid this abnormal acid reflux. However, failure of antireflux surgery has been reported in several publications and pathologic acid reflux test can be observed in 5% to 15% of GERD patients. 5,6 Zaninotto et al 6 reported 13.2% of reflux recurrence in patients with GERD (6.2% in patients with grade 0 to I esophagitis and 7% in patients with grade-II esophagitis, respectively). Presence of abnormal acid reflux has been reported after Nissen fundoplication as well as after Toupet or cardial calibration in a very similar percentage of cases. 7-9The restoration of the cardial anatomic integrity is followed by a successful outcome after surgery. On the contrary, some authors have published endoscopic or radiologic failures after fundoplication, with defective antireflux wrap associated with a high rate of symptomatic and objective reflux recurrence reaching up to 25% of cases. 2,10The purpose of this prospective study was to correlate the presence of postoperative radiologic and endoscopic defects of the new antireflux barrier after surgery and its association with persistence of symptoms, endoscopic esophagitis, hypotensive LES, and abnormal 24-hour pH monitoring. Patients and Methods Patients studiedIn this prospective ...

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Influence of wrap length on the effectiveness of Nissen and Toupet fundoplication: a prospective randomized study

Cited by 58 publications

References 28 publications

Pressure of the lower esophageal sphincter as a prognostic test result of antireflux surgery

Pressure of the lower esophageal sphincter as a prognostic test result of antireflux surgery

The effect of narrowed segment length on the degree of early postoperative dysphagia in laparoscopic Nissen fundoplication

Radiologic and Endoscopic Characteristics of Laparoscopic Antireflux Wrap: Correlation With Outcome

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