| Abstract |
Background: The effects of total (Nissen) and anterior partial (Watson) fundic wraps for the surgical treatment of gastroesophageal reflux disease (GERD) on the motor behavior of the esophagogastric axis are not fully assessed. The Aim the study was to assess any alterations in lower esophageal sphincter (LES) and gastric fundus motor parameters in GERD patients, after Nissen or Watson fundoplication. Patients-Methods: Twenty-four patients with documented GERD underwent either laparoscopic Nissen (12 cases) or laparoscopic Watson (12 cases) fundoplication. Pre- and post-operative stationary esophageal manometry included assessment of LES resting (LESRP) and postdeglutition relaxation (LESrP) pressures, intragastric pressure and LES transient relaxations at the left lateral and the upright positions, and after gastric distension. Results: Both types of fundoplication resulted in significant increase in LESRP (P<0.001) and LESrP (P<0.001) in both positions and after gastric distention. Intragastric pressure increased only after Nissen fundoplication in the postgastric distention state (P=0.01). Transient LES relaxations were equally abolished after both procedures. All postoperative changes were to similar level after either procedure, with the exception of intragastric pressure at the postgastric distention state, which was significantly higher after total than after partial fundoplication. Conclusions: Both Nissen and Watson antireflux procedure equally increase LES resting and postdeglutition relaxation pressures and abolish transient LES relaxations at all states. The significantly higher intragastric pressure at postgastric distention state after Nissen fundoplication, could possibly explain the higher incidence of epigastric fullness and discomfort after this type of antireflux surgery.
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Επίδραση φαρμακευτικών παραγόντων και αντιπαλινδρομικών επεμβάσεων στην κινητική συμπεριφορά του οισοφαγο-γαστρικού άξονα
