TAILORED AUGMENTATION OF THE LOWER ESOPHAGEAL SPHINCTER IN EXPERIMENTAL ANTIREFLUX OPERATIONS

Background: Modern upper GI function studies allow for the detection o f several pathophysiological factors that contribute to gastroesophage al reflux disease. The information obtained can lead to therapeutic co nsequences in patients with an indication for a surgical intervention, i.e., an individualized choice of antireflux procedure according to t he existing pathophysiologic defect. Methods: In an experimental study on mini-pigs the mechanical effect of four standardized antireflux op erations (anterior and posterior 180 degrees hemifundoplication, Nisse n-DeMeester and Nissen-Rossetti 360 degrees fundoplication) on the low er esophageal sphincter (LES) was investigated. It was the aim of the study to objectively determine the extent of changes in pressure and l ength parameters at the LES according to the performed antireflux proc edure. Results: It could be demonstrated that different degrees of fun dic wrap formation lead to a proportional mechanical effect at the LES according to the size of this wrap. Conclusion: Choosing a distinct t ype of fundoplication will allow for a tailored augmentation of the LE S according to the individual functional defect.