Factors affecting therapy outcomes of laparoscopic fundoplication for esophagitis

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Created On: 31/03/2021

Factors affecting therapy outcomes of laparoscopic fundoplication for esophagitis

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.

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Key take away

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

Background

Method

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.

Result

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.

Conclusion

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.

Source:

Surgery Today

Link:

https://link.springer.com/article/10.1007/s00595-021-02226-4

Article:

Factors affecting the treatment outcomes of laparoscopic fundoplication for erosive reflux esophagitis: findings of esophageal pathological function tests