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Is yield pressure at the cardia increased by effective fundoplication?
R C McGouran1, J M Galloway, F C Wells
1Department of Gastroenterology, Queen Elizabeth Hospital, King's Lynn, Norfolk.
Gut
|October 1, 1989
Summary
Fundoplication surgery significantly increased esophageal yield pressure in patients with gastroesophageal reflux disease. Successful operations correlated with higher yield pressure, aiding in healing esophagitis.
Area of Science:
- Gastroenterology
- Surgical Procedures
- Esophageal Physiology
Background:
- Gastroesophageal reflux disease (GERD) is a common condition requiring surgical intervention.
- Fundoplication is a surgical technique to treat GERD by reinforcing the lower esophageal sphincter.
- Measuring esophageal pressure is crucial for understanding treatment efficacy.
Purpose of the Study:
- To evaluate the impact of fundoplication on esophageal yield pressure.
- To correlate yield pressure changes with surgical success in treating esophagitis.
Main Methods:
- Prospective study involving 10 GERD patients undergoing fundoplication (5 Nissen, 5 Belsey Mark IV).
- Measurement of yield pressure at the cardia before and after surgery.
- Assessment of surgical success based on esophagitis healing or normalized 24-hour pH monitoring.
Main Results:
- A significant increase in yield pressure was observed in 8 out of 10 patients with successful outcomes.
- Patients with persistent esophagitis showed no significant rise in yield pressure.
- Both Nissen and Belsey Mark IV procedures demonstrated this effect.
Conclusions:
- Fundoplication surgery effectively increases esophageal yield pressure.
- Elevated yield pressure is a key indicator of successful GERD surgical treatment.
- Yield pressure measurement can serve as a valuable metric for assessing fundoplication outcomes.