Reflux and Belching After 270 Degree Versus 360 Degree Laparoscopic Posterior Fundoplication

Broeders, Joris A.; Bredenoord, Albert J.; Hazebroek, Eric J.; Broeders, Ivo A. M. J.; Gooszen, Hein G.; Smout, A. J. P. M.

doi:10.1097/sla.0b013e31823899f8

Cited by 42 publications

(33 citation statements)

References 51 publications

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“…Our study demonstrates that the total number of acid and weakly acidic reflux episodes at 14 years (15.0) are similar to results previously reported 16 at 6 months after Nissen fundoplication (7.4). In contrast, the total number of reflux episodes at 14 years is higher after anterior 180˚ fundoplication (40.4), with more liquid and mixed reflux episodes than after Nissen fundoplication.…”

Section: Discussionsupporting

confidence: 91%

“…19 It has recently been demonstrated that gas reflux and gastric belches are reduced less after posterior 270˚ partial fundoplication, resulting in fewer gas-related symptoms than after Nissen fundoplication at 6 months. 16 The long-term results evaluated in our current study were different. The number of gas reflux episodes at 14 years after anterior 180˚ (37.8) and Nissen fundoplication (55.8) were similar to the preoperative numbers described 16 for anterior 180˚ and Nissen fundoplication (36.3).…”

Section: Discussionmentioning

confidence: 56%

“…16 The long-term results evaluated in our current study were different. The number of gas reflux episodes at 14 years after anterior 180˚ (37.8) and Nissen fundoplication (55.8) were similar to the preoperative numbers described 16 for anterior 180˚ and Nissen fundoplication (36.3).…”

Section: Discussionmentioning

confidence: 56%

“…The first author recently demonstrated that gas reflux and gastric belches are reduced less after posterior partial fundoplication than after Nissen fundoplication, with similar reduction of acid and weakly acidic reflux at 6 months. 16 Cohort studies have raised concerns about the durability of control of reflux symptoms beyond 5 years after partial fundoplication [7][8][9][10] and such studies might have impeded wider application of these procedures. Our current study evaluated differences in objective outcomes at very late follow-up, 14 years after randomization, for laparoscopic anterior 180˚ partial vs. Nissen fundoplication.…”

Section: Discussionmentioning

confidence: 99%

“…[14][15][16] The 24-h impedance-pH tracings were manually analyzed using a dedicated software program (MMS, Enschede, The Netherlands). In order to minimize observer bias, the investigator analyzing these studies (JAB) was blinded to the patient characteristics and outcomes.…”

Section: Analysis Of Objective Outcome Datamentioning

confidence: 99%

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Objective Outcomes 14 Years After Laparoscopic Anterior 180-Degree Partial Versus Nissen Fundoplication

Broeders

Watson

et al. 2013

Annals of Surgery

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Please note that any alterations made during the publishing process may not appear in this version. Objective Outcomes 14 Years after Laparoscopic Anterior 180˚ Partial versus Nissen FundoplicationResults from a Randomized Trial Results: 18 patients (8 anterior, 10 Nissen) underwent objective testing and had a symptom profile similar to those who did not (n=59) have testing. Total esophageal acid exposure time and the total number of acid and weakly acidic reflux episodes per 24 h were higher after anterior fundoplication than after Nissen fundoplication. Proximal, mid-esophageal and distal reflux were proportionately increased after anterior 180˚ fundoplication. The number of liquid and mixed reflux episodes were also higher after anterior fundoplication, which was accompanied by higher clinical heartburn scores. There were no differences in gas reflux, gastric belches and supragastric belches, which is in line with the observation that gasrelated symptoms were similar for both groups. Mean LES resting and relaxation nadir pressure were lower after anterior fundoplication, which was reflected by lower dysphagia scores. Patient satisfaction is similar after both procedures.Conclusions: At 14 years after randomization, this study demonstrated that acid, weakly acidic, liquid and mixed reflux episodes are more common after anterior 180˚ fundoplication compared to Nissen fundoplication. On the other hand, gas reflux and gastric belching and patient satisfaction are similar for both procedures. Mean LES resting and relaxation nadir pressure are lower after anterior fundoplication. Overall these findings suggests less effective 4Archived at Flinders University: dspace.flinders.edu.au 5 reflux control after anterior 180˚ partial fundoplication, offset by less dysphagia, leading to a clinical outcome which is equivalent to Nissen fundoplication at late follow-up.

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Section: Discussionsupporting

confidence: 91%