Fjd. Porres et al., Manometric comprobation of esophagogastric junction competence after nissen fundoplication and its relation to the length of fundic wrap, WORLD J SUR, 24(7), 2000, pp. 870-873
We present 98 patients operated on by two techniques of 360-degree fundopli
cation due to gastroesopagheal reflux disease and divided in two groups: Gr
oup I comprised those who were given a conventional valve 5 cm in length, a
nd group II underwent a short fundoplication that did not surpass 1.5 cm, A
ll were subjected to preoperative esophageal manometry, with determination
of the pressure and length of the lower esophageal sphincter (LES) and the
motor behavior of the esophageal body. The postoperative manometric results
are analyzed, checking that after fundoplication there was a significant i
ncrease in tone and length of the LES (p < 0.00005); there were no differen
ces between the two groups (p = 0.9920 and p = 0.2160, respectively). The m
otor function of the esophageal body did not change after surgery, We concl
ude that even the smallest length of the fundic wrap dues not cause a reduc
tion in the pressure and Length of the manometric LES: that is, the antiref
lux effectiveness. measured by manometry, did not depend on the anterior le
ngth of the valvuloplasty.