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Post-fundoplication contrast studies: is there room for improvement?
M C Raeside1, D Madigan, J C Myers
1Department of Radiology, Royal Adelaide Hospital, Adelaide, SA, Australia.
The British Journal of Radiology
|July 28, 2011
Summary
Surgeons demonstrated higher accuracy in interpreting post-laparoscopic fundoplication contrast studies than radiologists. Standardized protocols are recommended for improved accuracy in assessing gastro-oesophageal reflux disease surgery outcomes.
Area of Science:
- Gastroenterology
- Surgical Imaging
- Radiology
Background:
- Laparoscopic fundoplication is the preferred surgical treatment for gastro-oesophageal reflux disease.
- Routine post-operative contrast studies are often performed to detect asymptomatic abnormalities and facilitate patient discharge.
Purpose of the Study:
- To evaluate the accuracy and interobserver reliability of surgeons and radiologists in interpreting post-operative contrast studies following laparoscopic fundoplication.
Main Methods:
- 11 surgeons and 13 radiologists retrospectively reviewed contrast studies of 20 patients.
- Observers assessed fundal wrap position, contrast leak, and gastro-oesophageal junction contrast hold-up.
- Interobserver reliability was calculated using the κ coefficient.
Main Results:
- Surgeons showed higher specificity in identifying normal studies (91.6% vs 78.9%).
- Both groups had similar sensitivity for abnormal studies (82.3% vs 85.2%).
- Surgeons had better agreement on wrap position (κ = 0.65 vs 0.54), but low agreement on wrap migration classification.
Conclusions:
- Radiologists require more information on laparoscopic anti-reflux surgery techniques.
- Standardized protocols for post-fundoplication contrast studies are necessary to improve interpretation consistency and accuracy.
