In patients with erosive reflux esophagitis, the esophageal clearance may impact the therapy outcome of laparoscopic fundoplication. 

A study was performed to explore the factors that impact laparoscopic fundoplication therapy efficacy in individuals suffering from erosive gastroesophageal reflux disease esophagitis, taking into consideration the findings of high-resolution manometry and multichannel intraluminal impedance pH.

The study included 102 individuals suffering from erosive gastroesophageal reflux disease diagnosed by endoscopy, who underwent laparoscopic fundoplication as the initial surgery. Participants were randomized into two arms: (i) A cured arm that included subjects whose esophagitis was cured postsurgery (n=96); and (ii) A recurrence arm included subjects who suffered recurrent esophagitis (n=6). The findings of high-resolution manometry and the multichannel intraluminal impedance pH were examined.

The multichannel intraluminal impedance pH illustrated that the number of refluxes longer than five minutes, acid reflux time, and the longest reflux time were considerably elevated in the recurrence arm compared to the cured arm. The high-resolution manometry demonstrated that only the distal contractile integral was remarkably reduced in the recurrence arm. 

The number of refluxes longer than five minutes and the longest reflux time were crucial factors impacting the therapeutic effect (considering the findings of multichannel intraluminal impedance pH) while the distal contractile integral value was most vital (considering the findings of high-resolution manometry) in reflux esophagitis patients undergoing laparoscopic fundoplication.