The effect of narrowed segment length on the degree of early postoperative dysphagia in laparoscopic Nissen fundoplication

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BACKGROUND/AIMS: Although laparoscopic Nissen fundoplication is the gold standard in the surgical treatment of gastroesophageal reflux disease, it may cause troublesome complications like dysphagia. In this study, we demonstrated the effect of narrowed segment length on early dysphagia in patients. MATERIALS AND METHODS: Forty-one patients who underwent laparoscopic Nissen fundoplication by a single surgeon between January 2007 and November 2008 were reviewed. Dysphagia scores were assessed by a question in the Gastrointestinal Quality of Life Index questionnaire and recorded preoperatively and at 1 month and 6 months. Barium esophagogram was performed for all patients at 1 month. Narrowed segment length was measured on esophagogram. Patients were divided into two groups (Group 1, ≤30 mm; Group 2, >30 mm). Dysphagia scores preoperatively and at 1 month and 6 months were compared between the two groups. RESULTS: The two groups were homogeneous in age, gender, body mass index, and preoperative dysphagia score. We were unable to demonstrate any difference in preoperative and postoperative dysphagia scores between the two groups. CONCLUSIONS: In this study, we used subjective data for grade of dysphagia and esophagogram for wrap length instead of manometric data. In our opinion, there is no effect of narrowed segment length on the degree of early postoperative dysphagia in patients undergoing laparoscopic Nissen fundoplication.

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