Omitting of bougie appears to be safe for the performance of the fundal wrap at laparoscopic Nissen fundoplication.
MINERVA CHIR 2013;
68:523-527. [PMID:
24101009]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
AIM
Some operative techniques in fundoplication seem to increase the incidence of obstructive symptoms. Some authors believe that using intraesophageal bougie and preparing a short and floppy valve in laparoscopic Nissen fundoplication will help to decrease any possible tight crus repair and wrap and so it is effective to decrease the prevalence of postoperative dysphagia. The aim of this study is to show that there is no absolute benefit of routine insertion of a bougie during laparoscopic Nissen fundoplication in relation to post-operative dysphagia.
METHODS
All patients who underwent laparoscopic Nissen fundoplication by a single surgeon between January 2001 and August 2011 were reviewed retrospectively. Esophageal bougie intubation was performed in none of the 154 patients. The operation technique, the duration of the operation, hospital stay and the improvement of the symptoms were assessed. The patients who had esophagitis with Barrett's esophagus and who had hiatal hernia that could not get benefit from medical therapy, were selected for the surgery. Laparoscopic Nissen fundoplication with cruroraphy were done in all patients.
RESULTS
Ninety-six of the patients were female and 58 were male. The mean symptom duration was 3.6±0.6 years. The only complication was dysphagia. In eighth week, dysphagia resolved in all patients.
CONCLUSION
Laparoscopic Nissen fundoplication can be safely performed without the routine use of an esophageal bougie and it does not increase the postoperative dysphagia rate.
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