TY - JOUR
T1 - Influence of spastic motor disorders of the esophageal body on outcomes from laparoscopic antireflux surgery
AU - Winslow, E. R.
AU - Clouse, R. E.
AU - Desai, K. M.
AU - Frisella, P.
AU - Gunsberger, T.
AU - Soper, N. J.
AU - Klingensmith, M. E.
PY - 2003/5/1
Y1 - 2003/5/1
N2 - Background: The clinical outcomes of laparoscopic antireflux surgery (LARS) in patients with the spectrum of nonspecific spastic esophageal motor disorders (NSSDs) are not known. Methods: From a prospective database of patients undergoing LARS between 1997 and 2000, those with preoperative manometry at our institution and follow-up at ≥6 months were identified. Results: Of the 121 patients, 35 had NSSDs. There were no differences in symptoms between groups preoperatively, but in the immediate postoperative period NSSD patients had more symptoms than nonspastic patients. At 18-month mean follow-up, NSSD patients reported significantly more heartburn (22% vs 7%), waterbrash (14% vs 4%), and medication usage (17% vs 5%) than nonspastic patients (p < 0.05 for each). Despite this difference, nearly all patients reported subjective improvement postoperatively, and the degree of improvement was similar between groups. Conclusions: Patients with NSSDs are more likely to have esophageal symptoms following LARS than subjects without these abnormalities. However, these patients still experience significant improvement in pre-operative symptoms.
AB - Background: The clinical outcomes of laparoscopic antireflux surgery (LARS) in patients with the spectrum of nonspecific spastic esophageal motor disorders (NSSDs) are not known. Methods: From a prospective database of patients undergoing LARS between 1997 and 2000, those with preoperative manometry at our institution and follow-up at ≥6 months were identified. Results: Of the 121 patients, 35 had NSSDs. There were no differences in symptoms between groups preoperatively, but in the immediate postoperative period NSSD patients had more symptoms than nonspastic patients. At 18-month mean follow-up, NSSD patients reported significantly more heartburn (22% vs 7%), waterbrash (14% vs 4%), and medication usage (17% vs 5%) than nonspastic patients (p < 0.05 for each). Despite this difference, nearly all patients reported subjective improvement postoperatively, and the degree of improvement was similar between groups. Conclusions: Patients with NSSDs are more likely to have esophageal symptoms following LARS than subjects without these abnormalities. However, these patients still experience significant improvement in pre-operative symptoms.
KW - Antireflux surgery
KW - Esophageal manometry
KW - Esophageal spasm
KW - Gastroesophageal reflux disease (GERD)
KW - Nissen fundoplication
UR - https://www.scopus.com/pages/publications/0038752832
U2 - 10.1007/s00464-002-8538-y
DO - 10.1007/s00464-002-8538-y
M3 - Article
C2 - 12618949
AN - SCOPUS:0038752832
SN - 0930-2794
VL - 17
SP - 738
EP - 745
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
IS - 5
ER -