Nonobstructive dysphagia and recovery of motor disorder after antireflux surgery

Background: Changes in motor disorder after Nissen 360degrees surgery were studied based on clinical signs of preoperative nonobstructive dysphagia. Materials and methods: Forty-seven patients undergoing Nissen 360degrees fundoplication for gastroesophageal reflux were studied with pH recording and esophageal manometry before and I year after fundoplication. Amplitude of contraction of the distal third of the esophagus (ACDTE) and the presence of primary propulsive waves were studied. Results: Fourteen patients had clinical signs of preoperative dysphagia. Of these, 50% had an ACDTE lower than 30 mm Hg, and 71.4% nonpropulsive waves (P <0.05). Forty-three percent and 30%, respectively, of patients with dysphagia recovered ACDTE and the presence of primary propulsive waves 1 year after the procedure, as compared with 66.6% (P <0.05) and 81.8% (P <0.01%) of patients without dysphagia. Conclusions: A correlation was found between preoperative dysphagia and esophageal motility disorders (P <0.05). One year after fundoplication, recovery was significantly higher in patients without preoperative dysphagia. (C) 2003 Excerpta Medica Inc. All rights reserved.