To assess whether careful dissection and isolation of vagus nerves from the three-quarter Nissen fundoplication wrap (a periesophageal posterior gastric wrap 270° in circumference) could modify the postoperative outcome and reduce postoperative gastric emptying disturbances.
Open randomized control trial.
Forty-two patients with proved esophageal reflux and indication for surgery, after informed consent.
A three-quarter Nissen fundoplication with (21 cases) or without (21 cases) dissection and exclusion of vagus nerves from the wrap.
Main Outcome Measures:
Standard questionnaire, acid reflux test, and gastric emptying study before and 3 months after surgery.
No difference was found between the groups. There was a correlation between preoperative and postoperative gastric emptying.
Exclusion of the vagus nerves from the three-quarter Nissen fundoplication wrap provides no advantage on postoperative gastric emptying and does not affect outcome of reflux surgery.(Arch Surg. 1994;129:814-818)
Peillon C, Manouvrier J, Labreche J, Kaeffer N, Denis P, Testart J. Should the Vagus Nerves Be Isolated From the Fundoplication Wrap?A Prospective Study. Arch Surg. 1994;129(8):814–818. doi:10.1001/archsurg.1994.01420320036006