Preoperative liquid gastric emptying rate does not predict outcome after fundoplication

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Pediatric Surgery

Background:

• Gastrointestinal reflux disease (GERD) management often involves antireflux surgery.
• Predicting surgical success in GERD patients is crucial for optimizing treatment.
• Gastric emptying (GE) rate is a potential factor influencing surgical outcomes.

Purpose of the Study:

• To evaluate preoperative gastric emptying (GE) rate as a predictor of outcome after antireflux surgery in GERD patients.
• To determine if slow GE is associated with recurrent GERD or persistent postoperative symptoms.

Main Methods:

• Radionuclide scintigraphy assessed GE rate using a standardized cow's milk meal.
• GE half time (T1/2), demographics, and GERD symptoms were recorded pre- and postoperatively.
• Nissen fundoplication was performed on 74 patients; 35 had preoperative GE studies.

Main Results:

• No significant difference in preoperative GE half time (T1/2) was found between patients with recurrent GERD and those without.
• Slow GE was not associated with recurrent GERD, vomiting, retching, prolonged feeding, or meal discomfort post-surgery.
• GERD recurred in 20% of patients, irrespective of their preoperative GE rate.

Conclusions:

• Preoperative gastric emptying rate is not a reliable predictor of outcomes following antireflux surgery for GERD.
• Slow GE does not correlate with increased risk of GERD recurrence or bothersome postoperative symptoms.