Concurrent fluoroscopy and manometry reveal differences in laparoscopic Nissen and anterior fundoplication

John Anderson, Jennifer Myers, David Watson, M Gabb, George Mathew, Glyn Jamieson

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

A prospective double-blind randomized trial was initiated to examine two types of laparoscopic fundoplication (Nissen and anterior). Thirty-two patients with proven gastroesophageal reflux disease presenting for primary laparoscopic antireflux surgery were randomized to undergo either Nissen fundoplication (N = 13) or anterior hemifundoplication (N = 19). Postoperative fluoroscopic and manometric examination was carried out concomitantly. Nissen fundoplication resulted in significantly greater elevation of resting (33.5 vs 23 mm Hg) and residual lower esophageal sphincter pressures (17 vs 6.5 mm Hg) and lower esophageal ramp pressure (26 vs 20.5 mm Hg) than the anterior partial fundoplication. A smaller radiologically measured sphincter opening diameter was seen following Nissen fundoplication (9 mm) compared with anterior fundoplication (12 mm). Lower esophageal ramp pressure correlated weakly (r = 0.37, P = 0.04) with postoperative dysphagia. It is concluded that the type of fundoplication performed significantly influences postoperative manometric and video barium radiology outcomes. The clinical relevance of this requires further investigation.
Original languageEnglish
Pages (from-to)847-853
Number of pages7
JournalDigestive Diseases and Sciences
Volume43
Issue number4
DOIs
Publication statusPublished - Apr 1998
Externally publishedYes

Keywords

  • fluoroscopy
  • manometry
  • laparascopic
  • fundoplication

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