Ielpo Benedetto, Martin Pedro, Vazquez Ricardo, Corripio Ramon, San Roman Juan, Acedo Felipe, La Puente Fernando, Torres Antonio, Gravante Gianpiero, Fernandez-Nespral Vicente
General Surgery Department, University Hospital Madrid Monteprincipe, Madrid, Spain.
Surg Laparosc Endosc Percutan Tech. 2011 Aug;21(4):267-70. doi: 10.1097/SLE.0b013e3182217d99.
It has been claimed that division of the short gastric vessels (SGV) during laparoscopic Nissen fundoplication (LNF) could reduce the risk of postoperative dysphagia. The aim of this study was to compare patients who underwent LNF with (SGV+) or without (SGV-) SGV division in our institution and present long-term results.
Retrospective case note review study of patients undergoing LNF with or without division of the SGV. Outcomes included DeMeester score, low esophageal sphincter resting pressure, and upper endoscopy. Operative time and patient satisfaction were also recorded.
Between February 2004 and February 2007, a total of 123 patients underwent LNF, 59 (48.0%) SGV- and 64 (52.0%) SGV+. The 2 groups were statistically comparable. There was no significant difference about median DeMeester score, low esophageal sphincter resting pressure, and long-term satisfaction score between the 2 groups at a mean of 4 years of follow-up (range, 36 to 60 mo). The mean operative time was statistically significantly lower in the SGV- patients (90 vs. 115 min, P=0.04).
Our experience suggests that LNF without division of SGV provides a good clinical and functional outcome, whereas division of the SGV is associated with longer operative times.
