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REFLUX AFTER OESOPHAGECTOMY: CAN A FUNDOPLICATION PREVENT IT?
Author(s) -
Aly A.,
Jamieson G.,
Watson D.,
Devitt P.,
Ackroyd R.,
Stoddard C.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04122_9.x
Subject(s) - medicine , reflux , anastomosis , dysphagia , incidence (geometry) , quality of life (healthcare) , surgery , esophagus , esophagectomy , esophageal cancer , cancer , disease , nursing , physics , optics
Oesophagectomy for oesophageal carcinoma is a major undertaking with a definite morbidity and mortality. Long term survival rates are low and post operative quality of life becomes increasingly important. When the anastomosis is in the thorax, gastro‐oesophageal reflux, particularly volume reflux symptoms are common and may significantly affect quality of life. It is proposed that a fundoplication at the anastomosis may help prevent reflux symptoms. Aims The aim of this study was to compare reflux after a fundoplication type anastomosis with a standard anastomosis in patients undergoing Ivor – Lewis Oesophagectomy. Study Design Prospective randomised trial utilising standardised symptom questionnaires applied in blinded fashion. Results The fundoplication anastomosis was associated with a significant reduction in the incidence of reflux (30% vs 70%) as well as reducing the incidence of severe reflux (7% vs 25%). A total fundoplication was more effective than a partial fundoplication in preventing severe reflux. Disturbance of sleep due to reflux was significantly reduced in the fundoplication group (18% vs 47%) as was the incidence of respiratory symptoms. The fundoplication anastomosis was not associated with an increase in dysphagia. Conclusion The fundoplication anastomosis protects patients from the symptoms of reflux after oesophagectomy and improves quality of life particularly with regard sleep disturbance.