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Should the vagus nerves be isolated from the fundoplication wrap? A prospective study
C Peillon1, J L Manouvrier, J Labreche
1Department of Surgery, Hôpital Charles Nicolle, Rouen, France.
Objective:
To assess whether careful dissection and isolation of vagus nerves from the three-quarter Nissen fundoplication wrap (a periesophageal posterior gastric wrap 270 degrees in circumference) could modify the postoperative outcome and reduce postoperative gastric emptying disturbances.
Design:
Open randomized control trial.
Setting:
University hospital.
Patients:
Forty-two patients with proved esophageal reflux and indication for surgery, after informed consent.
Interventions:
A three-quarter Nissen fundoplication with (21 cases) or without (21 cases) dissection and exclusion of vagus nerves from the wrap.
Main Outcome Measures:
Standard questionnaire, acid reflux test, and gastric emptying study before and 3 months after surgery.
Results:
No difference was found between the groups. There was a correlation between preoperative and post-operative gastric emptying.
Conclusion:
Exclusion of the vagus nerves from the three-quarter Nissen fundoplication wrap provides no advantage on postoperative gastric emptying and does not affect outcome of reflux surgery.