Antireflux surgery enhances gastric emptying

Abstract

Objective: To evaluate the influence of antireflux surgery on gastric emptying.

Design: Nonrandomized controlled trial 3 months before and after surgical intervention.

Setting: Secondary and tertiary referral center.

Patients and control subjects: Twenty consecutive patients (7 women, 13 men), mean age 49.2 years, with symptomatic, objectively confirmed gastroesophageal reflux disease and 10 healthy control subjects (3 women, 7 men), mean age 37.3 years.

Intervention: Laparoscopic or open Nissen fundoplication (in 1 case Toupet 180 degrees posterior hemifundoplication).

Main outcome measures: Gastric emptying scintigraphy, using solid food, in control subjects and patients 3 months before and 3 months after the operation; time to halving of the maximal activity and the activity remaining at 60, 100, and 120 minutes.

Results: Preoperative symptoms included pyrosis in 19 of 20 patients and regurgitation in 18. Three months postoperatively, 19 patients were symptom-free. The mean time to halving of the maximal activity decreased from 113 to 78 minutes (P = .001). Delayed gastric emptying was found postoperatively in 3 patients, compared with preoperative values, using activity at 60, 100, 120 minutes and the mean time to halving of the maximal activity as the variables. Compared with control subjects, gastric emptying was slower in patients preoperatively and faster postoperatively, but the difference was not statistically significant.

Conclusion: Gastric emptying is enhanced after antireflux surgery, along with cessation of symptoms and healing of esophagitis.