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Title: An antireflux anastomosis following esophagectomy: a randomized controlled trial.
Austin Authors: Aly, Ahmad ;Jamieson, Gary P;Watson, David I;Devitt, Peter G;Ackroyd, Roger;Stoddard, Chris J
Affiliation: Austin Hospital, Melbourne, Australia
Issue Date: 9-Dec-2009
Publication information: Journal of Gastrointestinal Surgery : Official Journal of the Society For Surgery of the Alimentary Tract 2009; 14(3): 470-5
Abstract: Reflux of duodeno-gastric fluid is a significant problem after esophagectomy with gastric conduit reconstruction. Symptoms may be severe and impact considerably upon the quality of life. Previous studies have suggested that a fundoplication type anastomosis may limit post-esophagectomy reflux.The purpose of this study was to determine whether a modified fundoplication at the gastro-esophageal anastomosis prevents reflux after esophagectomy.Prospective multicenter randomized controlled trial to compare a conventional end of esophagus to side of gastric conduit anastomosis with a modified fundoplication anastomosis in patients undergoing esophagectomy with intrathoracic anastomosis. Major outcomes were reflux symptoms, symptoms of dysphagia, and complications.Fifty-six patients were enrolled. The fundoplication anastomosis was associated with significantly lower incidence of reflux (40% vs 70%), as well as a reduced incidence of severe reflux (8% vs 30%). Disturbance of sleep due to reflux was significantly reduced in the fundoplication group (18% vs 47%) as was the incidence of respiratory symptoms. The fundoplication anastomosis was not associated with an increase in dysphagia, and there was no difference in complications between the two groups.Fundoplication anastomosis during esophagectomy is effective in protecting patients from reflux symptoms after esophagectomy and improves quality of life, particularly with regard to sleep disturbance.
Gov't Doc #: 19997983
DOI: 10.1007/s11605-009-1107-0
Journal: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
Type: Journal Article
Subjects: Aged
Anastomosis, Surgical.methods
Deglutition Disorders.etiology.prevention & control
Follow-Up Studies
Gastroesophageal Reflux.etiology.prevention & control
Middle Aged
Postoperative Complications.prevention & control
Prospective Studies
Quality of Life
Reference Values
Risk Assessment
Survival Analysis
Treatment Outcome
Appears in Collections:Journal articles

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