Motor function of the esophagus and the lower esophageal sphincter in children who undergo laparoscopic Nissen fundoplication

We have recently introduced laparoscopic magnetic sphincter augmentation (MSA) combined with hiatal hernia repair for treatment of patients with medically refractory gastroesophageal reflux disease (GERD). MSA is a novel surgical approach to the treatment of severe GERD, in which magnetic beads are secured around the lower esophageal sphincter, augmenting the lower esophageal sphincter function as an anti-reflux barrier. We hypothesize that patients undergoing MSA will achieve GERD relief, equal to that obtained after laparoscopic Nissen fundoplication. The GERD Health Related Quality of Life (GERD HRQL) Questionnaire is a validated clinical tool that was used to quantify patient outcomes in terms of GERD-related symptoms both on and off proton pump inhibitors and after acute radiation syndrome. We retrospectively reviewed data from patients at our institution enrolled in a prospective institutional review board–approved database “Registry Outcomes Anti-Reflux Surgery” that applies objective and subjective information about patients undergoing anti-reflux surgery. Information from both the database and patient HRQL scores were used to compare the effectiveness of medical intervention with acute radiation syndrome (laparoscopic Nissen fundoplication and MSA) in decreasing GERD-related symptoms in patients. Results are expressed as mean ± SE, and single-factor ANOVA test was used to compare groups. We found that MSA and laparoscopic fundoplication both lead to a comparable decrease in HRQL score and an increase in patient satisfaction when compared with patient's preoperative symptoms with maximum proton pump inhibitor use. In addition, our study shows that MSA is a safe minimally invasive anti-reflux procedure without the negative side-effects, such as gas bloat, inability to belch, and inability to vomit, commonly associated with NF.

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LINX Magnetic Esophageal Sphincter Augmentation vs Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease

World Journal of Laparoscopic Surgery with DVD ◽

10.5005/jp-journals-10033-1303 ◽

2017 ◽

Vol 10 (2) ◽

pp. 54-56

Author(s):

Bipin T Prasad

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Nissen Fundoplication ◽

Laparoscopic Nissen Fundoplication ◽

Esophageal Sphincter ◽

Laparoscopic Nissen

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Tu1272 Radiofrequency Energy Delivery to the Lower Esophageal Sphincter Improves Gastroesophageal Reflux Patient Reported Outcomes in Failed Laparoscopic Nissen Fundoplication Cohort

Gastroenterology ◽

10.1016/s0016-5085(16)34217-2 ◽

2016 ◽

Vol 150 (4) ◽

pp. S1248

Author(s):

Mark D. Noar ◽

Patrick Squires

Keyword(s):

Gastroesophageal Reflux ◽

Lower Esophageal Sphincter ◽

Patient Reported Outcomes ◽

Nissen Fundoplication ◽

Radiofrequency Energy ◽

Energy Delivery ◽

Patient Reported ◽

Radiofrequency Energy Delivery ◽

Esophageal Sphincter ◽

Laparoscopic Nissen

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Outcomes of Laparoscopic Nissen Fundoplication in Patients with Manometric Patterns of Esophageal Motility Disorders

The American Surgeon ◽

10.1177/000313481307900423 ◽

2013 ◽

Vol 79 (4) ◽

pp. 361-365 ◽

Cited By ~ 2

Author(s):

Bruna Dell'Acqua-CassÃO ◽

Fernando Augusto Mardiros-Herbella ◽

JosÉ F. Farah ◽

Adorisio Bonadiman ◽

Luciana C. Silva ◽

...

Keyword(s):

Hiatal Hernia ◽

Lower Esophageal Sphincter ◽

Esophageal Motility ◽

Nissen Fundoplication ◽

Esophageal Motility Disorders ◽

Motility Disorders ◽

Control Subjects ◽

Esophageal Sphincter ◽

Laparoscopic Nissen ◽

Manometric Pattern

The manometric pattern of either diffuse esophageal spasm (DES), nutcracker esophagus (NE), or hypertensive lower esophageal sphincter (HLES) in the presence of gastroesophageal reflux disease (GERD) is considered a secondary finding and treatment should be directed toward GERD. This study aims to evaluate the outcomes of laparoscopic Nissen fundoplication (LNF) in patients with manometric patterns of esophageal motility disorders. Patients with GERD confirmed by pH monitoring and manometric pattern of DES (simultaneous contractions 20 to 90% of wet swallows), NE (increased mean distal amplitude greater than 180 mmHg), or HLES (lower esophageal sphincter pressure greater than 45 mmHg) who underwent LNF were studied. A group of 50 consecutive patients with normal esophageal motility who underwent LNF were used as control subjects. Groups were comparable to control subjects for age, gender, preoperative symptoms, hiatal hernia, and Barrett's esophagus, except for NE that had younger individuals and a lower rate of hiatal hernia. Symptomatic outcome was similar when groups were compared with control subjects. Transient dysphagia was present in the postoperative period in 33, 7, 0, and 20 per cent of the patients with HLES, DES, NE, and control subjects, respectively. LNF is an adequate treatment for patients with GERD and manometric patterns of esophageal motility disorders.

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