EFFECTS OF NISSEN FUNDOPLICATION ON GASTROESOPHAGEAL REFLUX AND ESOPHAGEAL MOTOR FUNCTION

Background: Nissen fundoplication reduces gastro-oesophageal reflux ef fectively, but the mechanisms through which this effect is brought abo ut have remained rather obscure. Methods: In this study the effect of fundoplication on oesophageal acid exposure, oesophageal body motility , and lower oesophageal sphincter pressure (LOSP) was assessed prospec tively. Eleven patients were studied before and 3 months after a flopp y Nissen fundoplication. A Dent sleeve was used to measure LOSP, and a mbulatory pH and pressure monitoring were used to evaluate oesophageal motor function. Results: Gastro-oesophageal reflux was significantly decreased after fundoplication without an increase in LOSP. The motor function of the oesophageal body was not affected by the antireflux pr ocedure. Conclusions: Nissen fundoplication is an effective antireflux operation, even though the procedure does not increase LOSP, and the motility pattern of the oesophageal body is not affected by the constr uction of a floppy fundic wrap.