Surgical Treatment of Gastroesophageal Reflux – 180° or 270° Fundoplication Results on the Basis of Preoperative Sphincteric Pressure: Prospective Study in 45 Patients

Abstract

The aim of this study was to match the type of fundoplication and preoperative low esophageal sphincter (LES) pressure values. A posterior 180° fundoplication (180° FP) was performed when LES pressure was above 10 cm H₂0, and a 270° FP when it was below 10 cm H₂0. Among the 45 patients included in this study, 38 underwent a 270° FP and 7 a 180° FP. In patients with 270° FP, the median pre- and postoperative Kaye scores were 263.1 ± 130.6 and 1.8 ± 6.8, respectively; pre- and postoperative LES pressure values were 4.2 ± 2.9 and 24.5 ± 14.7 cm H₂0, respectively. In patients with 180° FP, the median pre- and postoperative Kaye scores were 265.1 ± 89 ± 4 and 3.3 ± 7.6, respectively; pre- and postoperative LES pressure were 13.6 ± 2.1 and 20.4 ± 6 cm H₂0, respectively. LES pressure could be the deciding factor in selecting the type of fundoplication, with which functional and pH-metric normalization could be achieved after surgery.