caa a22 4500 475780620 CHVBK 20180406123643.0 cr unu---uuuuu 170329e20000401xx s 000 0 eng 10.1007/s004640020060 doi (NATIONALLICENCE)springer-10.1007/s004640020060 Persistent dysphagia after laparoscopic vagotomy [Elektronische Daten] [Y. Shiino, C. J. Filipi, R. A. Hinder, T. Tomonaga, Z. T. Awad, R. E. Marsh] Background: Laparoscopic vagotomy represents a new and less invasive treatment for peptic ulcer disease, but the problem of postvagotomy dysphagia has not been solved. The aim of this study was to determine the etiologic factors related to long-term laparoscopic postvagotomy dysphagia. Methods: Two female and 11 male patients with a mean age of 48.5 years who underwent laparoscopic vagotomy were investigated retrospectively. Preoperative diagnosis included duodenal ulcer resistant to medical treatment, gastric hypersecretion, gastric outlet obstruction, cholelithiasis, and gastroesophageal reflux disease (GERD). Ten patients underwent laparoscopic highly selective vagotomy, and three patients had laparoscopic truncal vagotomy with gastrojejunostomy or pyloroplasty. Nine of these patients had a Nissen fundoplication in conjunction with the vagotomy. Results: The median long-term follow-up period was 47 months. Two patients complained of severe dysphagia, one of moderate dysphagia, and two of mild dysphagia. Neither type of vagotomy nor an additional fundoplication was correlated with the severity of postoperative long-term dysphagia. Severity of postoperative dysphagia was associated with severity of preoperative dysphagia (r= 0.752, p= 0.003) but not with heartburn (r= 0.358, p= 0.531) or regurgitation (r= 0.024, p= 0.938). The cause of preoperative dysphagia varied; however, all of these patients had GERD and consequent esophageal lesions. Conclusion: Preexisting dysphagia appears to play an integral role in persistent postoperative dysphagia. Care must be taken to construct a loose fundoplication in patients with dysphagia. Springer-Verlag New York Inc., 2000 Key words: Dysphagia — Fundoplication — Laparoscopy — Peptic ulcer — Vagotomy nationallicence Shiino Y. Department of Surgery, Creighton University, 601 North 30th Street, Omaha, NE 68131, USA, US aut Filipi C. J. Department of Surgery, Creighton University, 601 North 30th Street, Omaha, NE 68131, USA, US aut Hinder R. A. Department of Surgery, Mayo Clinic Jacksonville, 4500 San Pablo Road, Jacksonville, FL 32224, USA, US aut Tomonaga T. Department of Surgery, Creighton University, 601 North 30th Street, Omaha, NE 68131, USA, US aut Awad Z. T. Department of Surgery, Creighton University, 601 North 30th Street, Omaha, NE 68131, USA, US aut Marsh R. E. Department of Surgery, Creighton University, 601 North 30th Street, Omaha, NE 68131, USA, US aut Surgical Endoscopy Springer-Verlag 14/4(2000-04-01), 330-335 0930-2794 14:4<330 2000 14 464 https://doi.org/10.1007/s004640020060 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640020060 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shiino Y. Department of Surgery, Creighton University, 601 North 30th Street, Omaha, NE 68131, USA, US aut NATIONALLICENCE 700 1- Filipi C. J. Department of Surgery, Creighton University, 601 North 30th Street, Omaha, NE 68131, USA, US aut NATIONALLICENCE 700 1- Hinder R. A. Department of Surgery, Mayo Clinic Jacksonville, 4500 San Pablo Road, Jacksonville, FL 32224, USA, US aut NATIONALLICENCE 700 1- Tomonaga T. Department of Surgery, Creighton University, 601 North 30th Street, Omaha, NE 68131, USA, US aut NATIONALLICENCE 700 1- Awad Z. T. Department of Surgery, Creighton University, 601 North 30th Street, Omaha, NE 68131, USA, US aut NATIONALLICENCE 700 1- Marsh R. E. Department of Surgery, Creighton University, 601 North 30th Street, Omaha, NE 68131, USA, US aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/4(2000-04-01), 330-335 0930-2794 14:4<330 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer