Nissen Fundoplication after Failure of Endoluminal Fundoplication: Short-Term Results

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Background: Endoluminal fundoplcation (ELF) with EsophyX™ is a new attractive investigational procedure for the control of gastroesophageal reflux disease (GERD). The aim of this work is to evaluate the short-term results of Nissen fundoplication (NF) after failure of ELF. Method: During the period April 2007-January 2010, nine patients previously treated with ELF for GERD were submitted to laparoscopic NF for persistent reflux. Results: All patients were symptomatic for GERD, had a pathological esophageal acid exposure at multichannel intraluminal impedance (MII pH/24 h), and all of them were on proton pump inhibitor. Mean duration of the NF was 85 min (range, 56-104). There were no intraoperative complications. One patient had a postoperative mild peritoneal bleeding treated conservatively. After a mean follow-up of 24.9 months (4-34), all patients are asymptomatic for reflux. Two patients have a mild or moderate dysphagia at follow-up. Five patients underwent MII pH/24 h 1 year after surgery. Mean total reflux time was 0.3%, and acid reflux percent time was 0. Conclusions: Patients with persistent symptomatic reflux after a failing ELF can still undergo NF with good results; the endoluminal procedure does not seem to modify the results of the laparoscopic procedure, although an increased incidence of dysphagia pos-NF may be observed.

Original languageEnglish
Pages (from-to)439-443
Number of pages5
JournalJournal of Gastrointestinal Surgery
Issue number3
Publication statusPublished - Mar 2011


  • Endoluminal fundoplication (ELF)
  • Gastroesophageal reflux disease (GERD)
  • Nissen fundoplication (NF)

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology


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