SHOULD THE VAGUS NERVES BE ISOLATED FROM THE FUNDOPLICATION WRAP - A PROSPECTIVE-STUDY

Objective: To assess whether careful dissection and isolation of vagus nerves from the three-quarter Nissen fundoplication wrap (a periesoph ageal posterior gastric wrap 270 degrees in circumference) could modif y the postoperative outcome and reduce postoperative gastric emptying disturbances. Design: Open randomized control trial. Setting: Universi ty hospital. Patients: Forty-two patients with proved esophageal reflu x and indication for surgery, after informed consent. Interventions: A three-quarter Nissen fundoplication with (21 cases) or without (21 ca ses) dissection and exclusion of vagus nerves from the wrap. Main Outc ome Measures: Standard questionnaire, acid reflux test, and gastric em ptying study before and 3 months after surgery. Results: No difference was found between the groups. There was a correlation between preoper ative and postoperative gastric emptying. Conclusion: Exclusion of the vagus nerves from the three-quarter Nissen fundoplication wrap provid es no advantage on postoperative gastric emptying and does not affect outcome of reflux surgery.