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Though
patients with absent esophageal contractility still need surgery, laparoscopic
partial fundoplication was able to offer clinically relevant long-term
symptomatic relief in gastroesophageal reflux.
A recent
study published in the Journal of Gastrointestinal Surgery states that
laparoscopic partial fundoplication successfully offered effective symptom
control in gastroesophageal reflux without further worsening dysphagia in patients
with esophageal dysmotility.
In this
study, a total of 40 patients were enrolled, out of which 36 had undergone
anterior partial fundoplication and 4 Nissen fundoplication. The study
population was matched with 708 patients having normal motility on the basis of
age, gender, and fundoplication type. Symptoms like heartburn, dysphagia for
solids and liquids, regurgitation were assessed using the prospective symptom
assessment questionnaires. Furthermore, outcomes and satisfaction with surgery
were compared.
It was
observed that during the follow-up period, the patients having worse dysphagia
pre-operatively showed no significant difference in dysphagia scores
postoperatively (adjusted mean difference 1.09, p = 0.048). Also, no overall
difference in patient satisfaction was reported.
The authors concluded that
the laparoscopic partial fundoplication technique is effective for the
management of symptoms related to gastroesophageal reflux, but dysmotility
needs surgical management.
Journal of gastrointestinal surgery
Laparoscopic Fundoplication Is Effective Treatment for Patients with Gastroesophageal Reflux and Absent Esophageal Contractility
Steven Tran et al.
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