Dysphagia after laparoscopic Nissen fundoplication

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Patient Quality of Life

Background:

• Dysphagia is a known complication following laparoscopic Nissen fundoplication for gastro-oesophageal reflux disease.
• Existing literature shows wide variation in reported dysphagia frequencies (4-100%) after this procedure.
• There is a lack of data on the day-to-day occurrence of dysphagia in consecutive patient series.

Purpose of the Study:

• To determine the frequency and severity of dysphagia in the first 8 weeks after laparoscopic Nissen fundoplication.
• To establish a clear understanding of the temporal pattern of post-operative dysphagia.

Main Methods:

• A prospective study involving 40 consecutive patients undergoing laparoscopic Nissen fundoplication.
• Patients completed daily dysphagia diaries for 8 weeks post-surgery.
• Exclusion of patients with pre-existing dysphagia; a control group of 10 cholecystectomy patients was included.

Main Results:

• 93% of patients reported some dysphagia post-surgery.
• 44% experienced at least one day of bothersome dysphagia.
• Dysphagia peaked in the initial weeks, subsiding by 5-6 weeks; no dysphagia was reported in the control group.

Conclusions:

• Dysphagia is highly common after laparoscopic Nissen fundoplication, affecting nearly all patients.
• While often bothersome, dysphagia is usually transient, resolving within 5-6 weeks.
• A conservative approach and clear patient information regarding post-operative dysphagia are recommended.