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Clinical Outcome of
Nissen Fundoplication with Added Proximal Gastric Vagotomy versus
Nissen Fundoplication in Surgery of Gastroesophageal Reflux Disease
Hamdy
Abd El-Hady1 & Sherif El Saadany2
Departments of Surgery1 & Tropical Medicine2,
Faculty of Medicine, Tanta University, Egypt
Tanta Med. Sc. J 2009; 4(3):37-45
ICID: 903259
Article type: Original articleIC™ Value: 4.54
| Abstract provided by Publisher |
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Background/Aim: Gastroesophageal reflux disease (GERD) is one of the
most chronic disorders of gastrointestinal tract, 40% of symptomatic
GERD; develop complications with the potential sequaele of impaired
quality of life. The etiology of GERD is multifactorial. Nissen
fundoplication is the most widely antireflux operation worldwide and
is considered the gold standard. Recently, added proximal gastric
vagotomy to open Nissen fundoplication for surgery of GERD. The aim
of this study is to compare between Nissen fundoplication with added
proximal gastric vagotomy and Nissen only for treatment of GERD.
Patients & Methods: This study included a selected 54 patients of
GERD operated at Tanta University Hospital and divided into two
groups: group I (n=28) Nissen fundoplication was performed group II
(n=26) Nissen fundoplication with added proximal gastric vagotomy
was performed. Results: Age incidence ranged from (27-55) years with
a mean of (40.2)y in group I and (28-57) years with a mean of (42.9)
years in group II. Male to female ratio were 20/8 in group I and
21/5 in group II. The average of operative time was (75) minutes in
group I and (120.5) minutes in group II. Postoperative complications
were mild and accepted in both groups. As regards to reflux
symptoms, there were marked improvements in group II more than in
group I after 24 months but there is no difference could be found
between non reflux symptoms or gas related symptoms in both groups
after 24 month. Endoscopic assessment revealed that hiatus hernias
were disappeared completely with marked improvement of reflux
esophagitis. The ambulatory PH studies revealed a significant
improvement postoperatively in both groups. Conclusion: Added
proximal gastric vagotomy to open Nissen fundoplication for surgery
of GERD is easy, safe and producing an improvement of symptoms
especially reflux esophagitis and ambulatory PH-studies but it needs
a larger number and longer follow up for proper outcomes.
ICID 903259
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