Long-term result of total versus partial fundoplication after esophagomyotomy for primary esophageal motor disorders

World Journal of Surgery
Zi-Jiang ZhuAndre Duranceau

Abstract

The selection of the type of fundoplication or the necessity for an added fundoplication after esophagomyotomy (Heller's operation) for the treatment of achalasia remains controversial. The present retrospective study was designed to compare the long-term results of total and partial fundoplication on the myotomized esophagus. Between 1978 and 1998, a total of 64 consecutive patients with achalasia or diffuse esophageal spasm underwent esophagomyotomy and an antireflux operation via a left thoracotomy approach. Twenty-one had a total fundoplication (Nissen Group) during the period 1978-1983. After 1984 and until 1998, the remaining 43 patients were treated with addition of a Belsey Mark IV partial fundoplication (Belsey Group) to protect the myotomized esophagus. Clinical, radiologic, radionuclide transit, manometric, 24-h pH monitoring, and endoscopic assessments were obtained before and after the operation. There were no operative deaths or major complications in either group. After 6 years of follow-up the Belsey group was compared to the Nissen group. A higher frequency of dysphagia (7/18 versus 3/31; p=0.025), more barium stasis (9/13 versus 10/27; p=0.056), and increased radionuclide material retention (52.4% versus 29.2%...Continue Reading

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Citations

Mar 12, 2011·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Marco G Patti, Fernando A Herbella
Oct 7, 2008·World Journal of Gastroenterology : WJG·Teodoro Cordova-FragaRaquel Huerta-Franco
Feb 8, 2014·Gastroenterology Clinics of North America·Michael Mello, C Prakash Gyawali
Nov 26, 2008·Gastroenterology Clinics of North America·Natasha Walzer, Ikuo Hirano
Dec 18, 2014·World Journal of Surgery·Marco G Patti, Marco E Allaix
May 17, 2000·Journal of Pediatric Surgery·C EspositoP Montupet
May 26, 2017·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·C P GyawaliUNKNOWN International GERD Consensus Working Group
Jul 11, 2019·Current Gastroenterology Reports·Stephanie GarbarinoAmit Patel
Oct 3, 2018·Digestive Diseases and Sciences·Ishita DhawanFrank Friedenberg
Mar 10, 2020·Gastrointestinal Endoscopy Clinics of North America·Steven R DeMeester

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