LAPAROSCOPIC PARTIAL POSTERIOR FUNDOPLICATION IMPROVES POOR ESOPHAGEAL CONTRACTILITY IN PATIENTS WITH GASTROESOPHAGEAL REFLUX DISEASE

Objective: To investigate the effect of partial posterior fundoplicati on on oesophageal contractility in patients gastrooesophageal reflux d isease (GORD). Design: Follow-up study with 6 months of survey. Settin g: University hospital, Austria. Subjects: 24 consecutive patients wit h CORD and poor oesophageal contractility. Interventions: Laparoscopic partial posterior fundoplication. Oesophageal contractility was asses sed manometrically. Main outcome measures: Changes in measurements of mean contraction amplitudes in the distal oesophagus, the number of co ntractions with amplitudes of less than 30 mmHg, the number of interru pted and simultaneous contractions, and the total number of defective contractions. Results: 16 of the patients (67%) complained of dysphagi a preoperatively, and none postoperatively. The mean (SEM) amplitudes in the distal oesophagus improved significantly (level 4-42.4 mmHg (3. 5) compared with 31.8 mmHg (3.3), p = 0.03, and level 5-45.7 mmHg (3.8 ) compared with 32.6 mmHg (3.7), p = 0.02), the number of contractions with amplitudes below 30 mmHg decreased (18.0% (5.7) compared with 38 .3% (6.2), p = 0.02), as did the number of interrupted or defected con tractions (11.5% (3.6) compared with 26.3% (5.5), p = 0.03, and 29.5% (6.5) compared with 66.6% (5.1), p < 0.0001 respectively). There was n o significant effect on the number of simultaneous waves (p = 0.11). C onclusions: Partial posterior fundoplication improves poor oesophageal body motility. This results in improvement of preoperative dysphagia.