TITLE

Heartburn Is More Likely to Recur after Toupet Fundoplication than Nissen Fundoplication

AUTHOR(S)
Farrell, Timothy M.; Archer, Stephen B.; Galloway, Kathy D.; Branum, Gene D.; Smith, C. Daniel; Hunter, John G.
PUB. DATE
March 2000
SOURCE
American Surgeon;Mar2000, Vol. 66 Issue 3, p229
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Toupet (270 Degrees) fundoplication is commonly recommended for patients with gastroesophageal reflux (GER) and esophageal dysmotility. However, Toupet fundoplication may be less effective at protecting against reflux than Nissen (360 Degrees) fundoplication. We therefore compared the effectiveness and durability of both types of fundoplication as a function of preoperative esophageal motility. From January 1992 through January 1998, 669 patients with GER underwent laparoscopic fundoplication (78 Toupet, 591 Nissen). Patients scored heartburn, regurgitation, and dysphagia preoperatively, and at 6 weeks and 1 year postoperatively, using a 0 ("none") to 3 ("severe") scale. We compared symptom scores (Wilcoxon rank sum test) and redo fundoplication rates (Fisher exact test) in Toupet and Nissen patients. We also performed subgroup analyses on 81 patients with impaired esophageal motility (mean peristaltic amplitude, <30 mm Hg or peristalsis <70% of wet swallows) and 588 patients with normal esophageal motility. Toupet and Nissen patients reported similar preoperative heartburn, regurgitation, and dysphagia. At 6 weeks after operation, heartburn and regurgitation were similarly improved in both groups, but dysphagia was more prevalent among Nissen patients. After 1 year, heartburn and regurgitation were re-emerging in Toupet patients, and dysphagia was again similar between groups. Patients with impaired motility who have Nissen fundoplication are no more likely to suffer persistent dysphagia than their counterparts who have Toupet fundoplication. In addition, patients with normal motility are more likely to develop symptom recurrence after Toupet fundoplication than Nissen fundoplication, with no distinction in dysphagia rates. We conclude that since Toupet patients suffer more heartburn recurrence than Nissen patients, with similar dysphagia, selective use of Toupet fundoplication requires further study.
ACCESSION #
2962416

 

Related Articles

  • Impaired Esophageal Bolus Transit in Patients with Gastroesophageal Reflux Disease and Abnormal Esophageal Acid Exposure. Yu Kyung Cho; Myung-Gyu Choi; Chul Hyun Lim; Jin Su Kim; Jae Myung Park; In Seok Lee; Sang Woo Kim; Kyu-Yong Choi // Gut & Liver;Oct2012, Vol. 6 Issue 4, p440 

    Background/Aims: We assessed the bolus transit and motility characteristics in gastroesophageal reflux disease (GERD) patients with abnormal esophageal pH monitoring. Methods: We retrospectively reviewed the combined impedance-esophageal manometry data from consecutive patients who had abnormal...

  • Pharmacokinetic study of esomeprazole in the elderly. Hasselgren, G.; Hassan-Alin, M.; Andersson, T.; Claar-Nilsson, C.; Röhss, K.; Röhss, K // Clinical Pharmacokinetics;2001, Vol. 40 Issue 2, p145 

    Objective: Esomeprazole is the first proton pump inhibitor to be developed as an optical isomer for the treatment of patients with acid-related diseases. The aim of this study was to examine the pharmacokinetics and tolerability of esomeprazole in the elderly, relative to...

  • Proton pump inhibitors work best with breakfast. Lucas, Beverly D. // Patient Care;1/15/1999, Vol. 33 Issue 1, p25 

    Reports on the effectiveness of proton pump inhibitors when used with breakfast in persons with heartburn or gastroesophageal reflux disease. Control of stomach acid.

  • New approaches to treatment of GERD. Anderson Jr., Douglas C. // Drug Topics;10/2/2000, Vol. 144 Issue 19, p79 

    Provides information on medical approaches to treatment of gastroesophageal reflux disease. Pathophysiology; Diagnosis; Treatment.

  • Quit your bellyaching! Meyerowitz, Steve // Better Nutrition;Oct2000, Vol. 62 Issue 10, p30 

    Lists natural cures for heartburn. Enzymes; Herbs; Homeopathy; Raw juices; Supplements; Diet; Lifestyle changes.

  • Preoperative Evaluation of Patients with Gastroesophageal Reflux Disease. Patti, Marco G.; Fisichella, Piero M.; Perretta, Silvana // Journal of Laparoendoscopic & Advanced Surgical Techniques;Dec2001, Vol. 11 Issue 6, p327 

    All patients who are candidates for laparoscopic fundoplication for the treatment of gastroesophageal reflux disease (GERD) should have a symptom review, barium swallow imaging, endoscopy, esophageal manometry, and ambulatory pH monitoring. The presence of a typical primary symptom, an abnormal...

  • The Effect of Ineffective Esophageal Motility on Gastroesophageal Reflux Disease. Kasamatsu, Shingo; Matsumura, Tomoaki; Ohta, Yuki; Hamanaka, Shinsaku; Ishigami, Hideaki; Taida, Takashi; Okimoto, Kenichiro; Saito, Keiko; Maruoka, Daisuke; Nakagawa, Tomoo; Katsuno, Tatsuro; Fujie, Mai; Kikuchi, atsuko; arai, Makoto // Digestion;Apr2017, Vol. 95 Issue 3, p221 

    Background/Aims: Ineffective esophageal motility (IEM) is the most common gastrointestinal motility disorder. Studies have reported that IEM is related to gastroesophageal reflux disease (GERD). However, the relationship between IEM and GERD remains uncertain. This study aims to clarify this...

  • Gastroenterologist to offer acid-reflux procedure. Parish, Linn // Journal of Business (10756124);6/13/2002, Vol. 17 Issue 13, pB5 

    Discusses the plans of gastroenterologist Klaus Gottlieb of Spokane, Washington to offer the Stretta Procedure to treat patients of heartburn and gastroesophageal reflux disease. Information on acid reflux; Description and benefits of the procedure; Cost of the procedure.

  • Desperately Seeking Prilosec? Consider Alternatives.  // Tufts University Health & Nutrition Letter;May2005, Vol. 23 Issue 3, p8 

    Encourages heartburn patients to consider alternative medications to prilosec in the U.S. Reason for the shortage of prilosec; Medications for heartburn in gastroesophageal reflux disease patients; Costs of alternative medications.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics