Gastroesophageal disease and nausea: does fundoplication help or hurt?
Arch Surg
; 135(5): 545-9, 2000 May.
Article
em En
| MEDLINE
| ID: mdl-10807278
ABSTRACT
HYPOTHESIS:
Nausea associated with gastroesophageal reflux disease is cured by laparoscopic Nissen fundoplication (LNF).DESIGN:
Prospective cohort study of unselected patients who underwent LNF from January 1, 1995, through March 31, 1999. Patients were followed up by a physician for 6 to 36 months.SETTING:
A large community teaching hospital. PATIENTS One hundred consecutive patients with gastroesophageal reflux disease who underwent LNF; all patients were followed up. Patients were grouped according to the presence (group A, n = 33) or absence (group B, n = 67) of preoperative nausea. Interventions were LNF, esophageal manometry, 24-hour pH monitoring, and nuclear gastric emptying studies. MAIN OUTCOMEMEASURES:
Resolution of symptoms after LNF.RESULTS:
Nausea was the most common atypical symptom of gastroesophageal reflux disease, occurring in 33 patients (33%). There were no differences in esophageal manometry or 24-hour pH results between groups. There was a female preponderance in group A (55% vs 33%; P = .003). Patients in group A had a higher prevalence of preoperative dysphagia (P = .02). Patients with persistent postoperative nausea had a higher prevalence of cough (P = .003) and dysphagia (P = .009). The LNF was more effective in reducing heartburn (95% reduction) and regurgitation (95% reduction) than cough and dysphagia (60% reduction). There was a 79% reduction in the number of patients with nausea (33 to 7; P<.001).CONCLUSION:
Laparoscopic Nissen fundoplication is effective in eliminating nausea associated with gastroesophageal reflux disease and is not contraindicated in these patients.
Buscar no Google
Base de dados:
MEDLINE
Assunto principal:
Refluxo Gastroesofágico
/
Fundoplicatura
/
Náusea
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Arch Surg
Ano de publicação:
2000
Tipo de documento:
Article
País de afiliação:
Estados Unidos