Open AccessEffect of Nissen Fundoplication on Gastric Motor and Sensory Functions
Author(s) -
Mousa Hayat,
Caniano Donna A.,
Alhajj Maya,
Gibson Laurie,
Di Lorenzo Carlo,
Binkowitz Larry
Publication year - 2006
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/01.mpg.0000228115.14111.24
Subject(s) - medicine , nissen fundoplication , sensory system , physical medicine and rehabilitation , neuroscience , reflux , disease , biology
Objectives: Bloating, abdominal pain, and early satiety have been reported in up to 30% of patients after Nissen fundoplication. We hypothesized that these postsurgical complications in children and young adults are linked to either the effects of surgery on gastric sensation, compliance or motor function or to preexisting physiological abnormalities. Methods: We prospectively evaluated the effect of Nissen fundoplication on gastric sensory and motor functions in 13 children with gastroesophageal reflux. Gastric barostat and mixed meal gastric emptying studies were performed before surgery in all patients and were repeated after surgery in 8 and 9 children, respectively. Results: Thirteen patients (median age, 7 years; range, 6 months to 18 years) underwent open Nissen (n = 6) or laparoscopic Nissen fundoplication (n = 7). After fundoplication, patients had significantly higher minimal distending pressure values (10 mm Hg vs 3 mm Hg pre‐Nissen, respectively; P < 0.001), reduced gastric compliance (slope values of 8.39 mm Hg vs 9.15 mm Hg, respectively, P < 0.001) and significantly higher pain scores ( P < 0.001). Presurgery and postsurgery gastric emptying at 60, 90 and 120 minutes after feeding showed no significant changes. Conclusions: After Nissen fundoplication, children with gastroesophageal reflux manifest the following: (1) reduction in gastric compliance, (2) increase in minimal gastric distending pressure, (3) exacerbation of the sensations discomfort with gastric distension and (4) no effect on gastric emptying.