Altered esophageal sensory-motor function in patients with persistent symptoms after Nissen fundoplication

Jose M. Remes-Troche, James Maher, Ranjit Mudipalli, Satish Sanku Chander Rao

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: The pathophysiology of persistent gastroesophageal reflux disease (GERD) symptoms after antireflux surgery is unclear. We assessed esophageal sensorimotor function in patients with GERD before and after Nissen fundoplication (NF). Methods: Sensory and biomechanical properties were evaluated before surgery using impedance planimetry in 17 GERD patients and 16 healthy volunteers. All patients underwent standard laparoscopic NF. Eight GERD patients with persistent symptoms after surgery underwent repeat evaluations at least 12 months after surgery. Results: At baseline, GERD patients had lower thresholds for first perception (P < .001), discomfort (P < .001), and pain (P < .001) compared with controls. The esophagus was more reactive (P = .001) and less distensible (P = .04) in patients than controls. After NF, in patients with persistent symptoms, the sensory thresholds were unchanged (P > .05) but esophageal wall reactivity decreased (P = .001), and distensibility improved (P = .025). Conclusions: NF improves esophageal biomechanical dysfunction but not the underlying hypersensitivity. Visceral hypersensitivity of the esophagus may explain persistent symptoms after NF.

Original languageEnglish (US)
Pages (from-to)200-205
Number of pages6
JournalAmerican Journal of Surgery
Volume193
Issue number2
DOIs
StatePublished - Feb 1 2007
Externally publishedYes

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Fundoplication
Gastroesophageal Reflux
Hypersensitivity
Electric Impedance
Reoperation
Esophagus
Healthy Volunteers

Keywords

  • Esophagus
  • Nissen fundoplication
  • Sensorimotor function
  • refractory GERD

ASJC Scopus subject areas

  • Surgery

Cite this

Altered esophageal sensory-motor function in patients with persistent symptoms after Nissen fundoplication. / Remes-Troche, Jose M.; Maher, James; Mudipalli, Ranjit; Rao, Satish Sanku Chander.

In: American Journal of Surgery, Vol. 193, No. 2, 01.02.2007, p. 200-205.

Research output: Contribution to journalArticle

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