caa a22 4500 475779207 CHVBK 20180406123639.0 cr unu---uuuuu 170329e20000901xx s 000 0 eng 10.1007/s004640000232 doi (NATIONALLICENCE)springer-10.1007/s004640000232 Efficacy of a 90° anterior fundoplication vs a total fundoplication in an experimental model [Elektronische Daten] [P. Yau, D. I. Watson, N. Ascott, T. Lafullarde, G. G. Jamieson] Background: The surgical treatment of gastroesophageal reflux disease (GERD) has improved greatly, so that excellent long-term control of symptoms can now be achieved. At present, the gold standard for treatment is the Nissen fundoplication. However, this procedure produces side effects in some patients, including persistent dysphagia, epigastric bloating, and excessive flatulence. As a result, some surgeons who have recommended the use of a partial fundoplication to lessen the occurrence of these side effects. The aim of this study was to determine the efficacy of a laparoscopically constructed 90° anterior fundoplication and to compare this method with the Nissen fundoplication. Methods: Twelve domestic white pigs underwent initial esophageal myotomy to ensure an incompetent lower esophageal sphincter. These animals were then randomized to undergo either a total fundoplication or a 90° wrap. All procedures were completed laparoscopically. Resting lower esophageal sphincter pressures were measured immediately and at 2 weeks postoperatively with a water-perfused esophageal manometry catheter incorporating a Dent sleeve. The efficacy of the antireflux barrier was determined at 2 weeks after surgery by fundoplication yield studies. Results: Both the total fundoplication and the 90° wrap produced an increase in resting lower esophageal sphincter pressure and restored adequate competence to the gastroesophageal junction in the early postoperative period. Conclusion: A laparoscopically completed 90° anterior fundoplication restores lower esophageal sphincter competence in the early postoperative period. Clinical studies examining the long-term results and significant side effects of this procedure are required to establish the place for this procedure in the antireflux surgery armamentarium. Springer-Verlag New York Inc., 2000 Key words: Laparoscopy — Gastroesophageal reflux disease — Fundoplication — Antireflux surgery — Pig — Anatomical repair nationallicence Yau P. Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia, Australia aut Watson D. I. Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia, Australia aut Ascott N. Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia, Australia aut Lafullarde T. Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia, Australia aut Jamieson G. G. Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia, Australia aut Surgical Endoscopy Springer-Verlag 14/9(2000-09-01), 830-833 0930-2794 14:9<830 2000 14 464 https://doi.org/10.1007/s004640000232 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000232 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Yau P. Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia, Australia aut NATIONALLICENCE 700 1- Watson D. I. Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia, Australia aut NATIONALLICENCE 700 1- Ascott N. Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia, Australia aut NATIONALLICENCE 700 1- Lafullarde T. Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia, Australia aut NATIONALLICENCE 700 1- Jamieson G. G. Department of Surgery, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia, Australia aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/9(2000-09-01), 830-833 0930-2794 14:9<830 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer