Influence of spastic motor disorders of the esophageal body on outcomes from laparoscopic antireflux surgery

E. R. Winslow*, R. E. Clouse, K. M. Desai, P. Frisella, T. Gunsberger, N. J. Soper, M. E. Klingensmith

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Background: The clinical outcomes of laparoscopic antireflux surgery (LARS) in patients with the spectrum of nonspecific spastic esophageal motor disorders (NSSDs) are not known. Methods: From a prospective database of patients undergoing LARS between 1997 and 2000, those with preoperative manometry at our institution and follow-up at ≥6 months were identified. Results: Of the 121 patients, 35 had NSSDs. There were no differences in symptoms between groups preoperatively, but in the immediate postoperative period NSSD patients had more symptoms than nonspastic patients. At 18-month mean follow-up, NSSD patients reported significantly more heartburn (22% vs 7%), waterbrash (14% vs 4%), and medication usage (17% vs 5%) than nonspastic patients (p < 0.05 for each). Despite this difference, nearly all patients reported subjective improvement postoperatively, and the degree of improvement was similar between groups. Conclusions: Patients with NSSDs are more likely to have esophageal symptoms following LARS than subjects without these abnormalities. However, these patients still experience significant improvement in pre-operative symptoms.

Original languageEnglish (US)
Pages (from-to)738-745
Number of pages8
JournalSurgical Endoscopy and Other Interventional Techniques
Volume17
Issue number5
DOIs
StatePublished - May 1 2003

Keywords

  • Antireflux surgery
  • Esophageal manometry
  • Esophageal spasm
  • Gastroesophageal reflux disease (GERD)
  • Nissen fundoplication

ASJC Scopus subject areas

  • Surgery

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