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https://hdl.handle.net/2440/10107
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Type: | Journal article |
Title: | Effect of fundoplication on transient lower oesophageal sphincter relaxation and gas reflux |
Author: | Johnsson, F. Holloway, R. Ireland, A. Jamieson, G. Dent, J. |
Citation: | British Journal of Surgery, 1997; 84(5):686-689 |
Publisher: | BLACKWELL SCIENCE LTD |
Issue Date: | 1997 |
ISSN: | 0007-1323 1365-2168 |
Abstract: | <h4>Background</h4>Fundoplication is used widely to treat severe gastro-oesophageal reflux disease. Difficulty in belching and increased flatulence are common side-effects. Transient lower oesophageal sphincter (LOS) relaxation is important to help vent gas from the stomach. The effect of fundoplication on LOS function and gas reflux was therefore investigated.<h4>Methods</h4>Oesophageal manometry was performed before operation and 3-15 months after fundoplication in 14 patients with reflux disease who had a total (360 degrees) fundoplication. Five patients also had highly selective vagotomy. Gastric distension was induced by 750 ml carbon dioxide.<h4>Results</h4>Fundoplication reduced the median number of episodes of gas reflux during 10 min of gastric distension from 5 (interquartile range (i.q.r.) 3-7) to 0 (i.q.r. 0), and the median number of transient LOS relaxations from 4 (i.q.r. 2-6) to 0 (i.q.r. 0-1). Fundoplication did not affect basal LOS pressure but significantly increased nadir pressure during swallow-induced relaxation.<h4>Conclusion</h4>Fundoplication controls reflux by inhibiting the triggering of transient LOS relaxation and by preventing the complete ablation of pressure at the gastro-oesophageal junction during LOS relaxation. These effects may also contribute to the side-effects of the operation. |
Keywords: | Esophagus Humans Gastroesophageal Reflux Eructation Gases Postoperative Care Preoperative Care Fundoplication Manometry Muscle Relaxation Pressure Adult Aged Middle Aged Female Male |
DOI: | 10.1002/bjs.1800840533 |
Published version: | http://dx.doi.org/10.1002/bjs.1800840533 |
Appears in Collections: | Aurora harvest 2 Surgery publications |
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