Nonobstructive dysphagia and recovery of motor disorder after antireflux surgery

Am J Surg. 2003 Feb;185(2):103-7. doi: 10.1016/s0002-9610(02)01200-x.

Abstract

Background: Changes in motor disorder after Nissen 360 degrees surgery were studied based on clinical signs of preoperative nonobstructive dysphagia.

Materials and methods: Forty-seven patients undergoing Nissen 360 degrees fundoplication for gastroesophageal reflux were studied with pH recording and esophageal manometry before and 1 year after fundoplication. Amplitude of contraction of the distal third of the esophagus (ACDTE) and the presence of primary propulsive waves were studied.

Results: Fourteen patients had clinical signs of preoperative dysphagia. Of these, 50% had an ACDTE lower than 30 mm Hg, and 71.4% nonpropulsive waves (P <0.05). Forty-three percent and 30%, respectively, of patients with dysphagia recovered ACDTE and the presence of primary propulsive waves 1 year after the procedure, as compared with 66.6% (P <0.05) and 81.8% (P <0.01%) of patients without dysphagia.

Conclusions: A correlation was found between preoperative dysphagia and esophageal motility disorders (P <0.05). One year after fundoplication, recovery was significantly higher in patients without preoperative dysphagia.

MeSH terms

  • Deglutition Disorders / etiology*
  • Esophagus / metabolism
  • Esophagus / physiopathology*
  • Female
  • Fundoplication* / adverse effects
  • Gastroesophageal Reflux / physiopathology
  • Gastroesophageal Reflux / rehabilitation*
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Manometry
  • Peristalsis
  • Postoperative Complications