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 20 April 2018

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News

Antireflux surgery acceptable in patients with delayed gastric emptying

Delayed gastric emptying is not a contraindication for antireflux surgery, claims a team from Utrecht, the Netherlands.

News image

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The researchers investigated the impact of delayed gastric emptying on the outcome of antireflux surgery, and reported their findings in August's Annals of Surgery.

36 patients (26 men, mean age 43 years) were studied before and 3 months after Nissen fundoplication.

Gastric emptying was not included in the decision for surgery.

Reflux-related and dyspeptic symptoms were scored before and at 3, 6, and 12 months after surgery.

Delayed gastric emptying does not contraindicate antireflux surgery.
Annals of Surgery
The team found that 26 patients had normal, and 10 had delayed gastric emptying before surgery.

Nissen fundoplication, on average, enhanced gastric emptying for solids in both subgroups. There was a combination of a decrease in mean lag phase, emptying rate, and T50.

Fundoplication abolished the preoperative difference in intragastric distribution between patients with and without delayed gastric emptying.

Patients with normal gastric emptying before surgery showed an increase in early postprandial satiety. In those with delayed emptying, this was not observed.

Preoperative T50 for liquid gastric emptying correlated with postoperative nausea at 3 months in patients with normal gastric emptying.

In patients with delayed emptying, preoperative correlations between lag phase for liquids and nausea, respectively, and early satiety were significant. A correlation was also noted between T50 for liquids and vomiting.

Dr Janiek E. Bais, of Utrecht University, said on behalf of fellow authors, "Nissen fundoplication equalizes the preoperative difference in intragastric distribution and accelerates gastric emptying.

"It does so without an effect on symptoms in patients with pre-existing delayed gastric emptying. However, there is an increase in early satiety in patients with normal gastric emptying."

"Delayed gastric emptying is not a contraindication for antireflux surgery," it was concluded.

Ann Surg 2001; 234 (2): 139-46
08 August 2001

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