Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Langenbeck's Archives of Surgery
Erschienen in: Langenbeck's Archives of Surgery 6/2005

01.11.2005 | Current Concepts in Clinical Surgery

The Nissen fundoplication: indication, technical aspects and postoperative outcome

verfasst von: H. Wykypiel, G. J. Wetscher, P. Klingler, K. Glaser

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 6/2005

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Gastroesophageal reflux disease (GERD) is the most common foregut disease, with a great impact on quality of life and with intestinal, respiratory and cardiac symptoms and implications of carcinogenesis of the oesophagus. Medical therapy often fails, due to the complex pathophysiology of GERD. Surgery can cure the disease, since it is able to restore the anti-reflux barrier. It improves quality of life and prevents carcinogenesis.

Methods

Review of the literature and presentation of our own experience and data in a series of more than 4,000 evaluated patients referred for suspected reflux disease, of whom 382 have been operated on.

Conclusion

The laparoscopic Nissen fundoplication is the most commonly used operation technique. It provides good long-term results in the majority of patients. However, due to an increase of outflow resistance of the oesophagus this operation is associated with some postoperative side effects. Therefore, alternative anti-reflux procedures may be indicated in selected patients.
Literatur
1.
Redmond E, Wetscher G (1993) Introduction. In: Hinder R (ed) Gastroesophageal reflux disease. Landes, Austin, pp 1–6
2.
Stein HJ, Barlow AP, DeMeester TR, Hinder RA (1992) Complications of gastroesophageal reflux disease. Role of the lower esophageal sphincter, esophageal acid and acid/alkaline exposure, and duodenogastric reflux. Ann Surg 216:35–43PubMed
3.
Wetscher G, Redmond E, Vitito L (1993) Pathophysiology of gastroesophageal reflux disease. In: Hinder R (ed) Gastroesophageal reflux disease. Medical Intelligence Unit, Landes, Austin, pp 7–29
4.
Gadenstatter M, Prommegger R, Klingler A, Schwelberger H, Weiss HG, Glaser K, Wetscher GJ (2000) Alterations of gut neuropeptides in gastroesophageal reflux disease are resolved after antireflux surgery. Am J Surg 180:483–487CrossRefPubMed
5.
Perdikis G, Wilson P, Hinder RA, Redmond EJ, Wetscher GJ, Saeki S, Adrian TE (1994) Gastroesophageal reflux disease is associated with enteric hormone abnormalities. Am J Surg 167:186–191; discussion 191–192CrossRefPubMed
6.
Eckardt VF (1988) Does healing of esophagitis improve esophageal motor function? Dig Dis Sci 33:161–165PubMed
7.
Stelzner F, Lierse W (1968) The angiomuscular dilation closing of the terminal esophagus. Langenbecks Arch Chir 321:35–64PubMed
8.
Schwizer W, Hinder RA, DeMeester TR (1989) Does delayed gastric emptying contribute to gastroesophageal reflux disease? Am J Surg 157:74–81CrossRefPubMed
9.
Wetscher GJ, Hinder RA, Bagchi D, Hinder PR, Bagchi M, Perdikis G, McGinn T (1995) Reflux esophagitis in humans is mediated by oxygen-derived free radicals. Am J Surg 170:552–556; discussion 556–557CrossRefPubMed
10.
Wetscher GJ, Hinder RA, Kretchmar D, Stinson R, Perdikis G, Smyrk T, Klingler PJ, Adrian TE (1996) Duodenogastric reflux causes growth stimulation of foregut mucosa potentiated by gastric acid blockade. Dig Dis Sci 41:2166–2173PubMed
11.
Wykypiel H, Gadenstaetter M, Wetscher GJ (1999) Reflux-induced apoptosis of the esophageal mucosa is inhibited in Barrett’s. Acta Chir Austriaca 31:362–364
12.
Krishnadath KK, Tilanus HW, van Blankenstein M, Hop WC, Teijgeman R, Mulder AH, Bosman FT, van Dekken H (1995) Accumulation of genetic abnormalities during neoplastic progression in Barrett’s esophagus. Cancer Res 55:1971–1976PubMed
13.
Jenkins GJ, Doak SH, Parry JM, D’Souza FR, Griffiths AP, Baxter JN (2002) Genetic pathways involved in the progression of Barrett’s metaplasia to adenocarcinoma. Br J Surg 89:824–837CrossRefPubMed
14.
Wykypiel H, Gadenstaetter M, Granderath F, Klingler P, Wetscher G (2002) Pathophysiology of gastrointestinal reflux disease (GERD) with respect to reflux-induced carcinogenesis. Eur Surg 34:196–302CrossRef
15.
Jankowski JA, Wright NA, Meltzer SJ, Triadafilopoulos G, Geboes K, Casson AG, Kerr D, Young LS (1999) Molecular evolution of the metaplasia–dysplasia–adenocarcinoma sequence in the esophagus. Am J Pathol 154:965–973PubMed
16.
Loffeld RJ (2001) Reflux complaints, symptom score and the use of medication in patients with reflux esophagitis: results of a long term follow-up study. Can J Gastroenterol 15:505–508PubMed
17.
Wetscher GJ, Glaser K, Hinder RA, Perdikis G, Klingler P, Bammer T, Wieschemeyer T, Schwab G, Klingler A, Pointner R (1997) Respiratory symptoms in patients with gastroesophageal reflux disease following medical therapy and following antireflux surgery. Am J Surg 174:639–642; discussion 642–643CrossRefPubMed
18.
Gadenstatter M, Wykypiel H, Schwab GP, Profanter C, Wetscher GJ (1999) Respiratory symptoms and dysphagia in patients with gastroesophageal reflux disease: a comparison of medical and surgical therapy. Langenbecks Arch Surg 384:563–567
19.
Kamolz T, Bammer T, Wykypiel H Jr, Pasiut M, Pointner R (2000) Quality of life and surgical outcome after laparoscopic Nissen and Toupet fundoplication: one-year follow-up. Endoscopy 32:363–368CrossRefPubMed
20.
Klinkenberg-Knol EC, Festen HP, Jansen JB, Lamers CB, Nelis F, Snel P, Luckers A, Dekkers CP, Havu N, Meuwissen SG (1994) Long-term treatment with omeprazole for refractory reflux esophagitis: efficacy and safety. Ann Intern Med 121:161–167PubMed
21.
Wetscher GJ, Profanter C, Gadenstatter M, Perdikis G, Glaser K, Hinder RA (1997) Medical treatment of gastroesophageal reflux disease does not prevent the development of Barrett’s metaplasia and poor esophageal body motility. Langenbecks Arch Chir 382:95–99CrossRefPubMed
22.
Klaus A, Gadenstaetter M, Mühlmann G, Kirchmayr W, Profanter C, Achem S, Wetscher G (2003) Selection of patients with gastroesophageal reflux disease for antireflux surgery based on esophageal manometry. Dig Dis Sci 48:1719–1722CrossRefPubMed
23.
Wetscher GJ, Glaser K, Gadenstaetter M, Profanter C, Hinder RA (1999) The effect of medical therapy and antireflux surgery on dysphagia in patients with gastroesophageal reflux disease without esophageal stricture. Am J Surg 177:189–192CrossRefPubMed
24.
Spechler SJ (1992) Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans. The Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group. N Engl J Med 326:786–792PubMed
25.
Bammer T, Hinder RA, Klaus A, Klingler PJ (2001) Five-year to eight-year outcome of the first laparoscopic Nissen fundoplications. J Gastrointest Surg 5:42–48CrossRefPubMed
26.
Hinder RA, Filipi CJ, Wetscher G, Neary P, DeMeester TR, Perdikis G (1994) Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease. Ann Surg 220:472–481; discussion 481–483PubMed
27.
Wetscher GJ, Glaser K, Wieschemeyer T, Gadenstaetter M, Prommegger R, Profanter C (1997) Tailored antireflux surgery for gastroesophageal reflux disease: effectiveness and risk of postoperative dysphagia. World J Surg 21:605–610CrossRefPubMed
28.
Hinder RA, Stein HJ, Bremner CG, DeMeester TR (1989) Relationship of a satisfactory outcome to normalization of delayed gastric emptying after Nissen fundoplication. Ann Surg 210:458–464; discussion 464–465PubMed
29.
Stein HJ, Kauer WK, Feussner H, Siewert JR (1998) Bile reflux in benign and malignant Barrett’s esophagus: effect of medical acid suppression and Nissen fundoplication. J Gastrointest Surg 2:333–341CrossRefPubMed
30.
Wetscher GJ, Gadenstaetter M, Klingler PJ, Weiss H, Obrist P, Wykypiel H, Klaus A, Profanter C (2001) Efficacy of medical therapy and antireflux surgery to prevent Barrett’s metaplasia in patients with gastroesophageal reflux disease. Ann Surg 234:627–632CrossRefPubMed
31.
Oelschlager BK, Barreca M, Chang L, Oleynikov D, Pellegrini CA (2003) Clinical and pathologic response of Barrett’s esophagus to laparoscopic antireflux surgery. Ann Surg 238:458–464; discussion 464–466CrossRefPubMed
32.
Gurski RR, Peters JH, Hagen JA, DeMeester SR, Bremner CG, Chandrasoma PT, DeMeester TR (2003) Barrett’s esophagus can and does regress after antireflux surgery: a study of prevalence and predictive features. J Am Coll Surg 196:706–712; discussion 712–713CrossRefPubMed
33.
Donahue PE, Samelson S, Nyhus LM, Bombeck CT (1985) The floppy Nissen fundoplication. Effective long-term control of pathologic reflux. Arch Surg 120:663–668
34.
DeMeester TR, Bonavina L, Albertucci M (1986) Nissen fundoplication for gastroesophageal reflux disease. Evaluation of primary repair in 100 consecutive patients. Ann Surg 204:9–20PubMed
35.
Perdikis G, Hinder RA, Lund RJ, Raiser F, Katada N (1997) Laparoscopic Nissen fundoplication: where do we stand? Surg Laparosc Endosc 7:17–21CrossRefPubMed
36.
Campos GM, DeMeester SR, Peters JH, Oberg S, Crookes PF, Hagen JA, Bremner CG, Sillin LF III, Mason RJ, DeMeester TR (2001) Predictive factors of Barrett esophagus: multivariate analysis of 502 patients with gastroesophageal reflux disease. Arch Surg 136:1267–1273
37.
Lundell L, Miettinen P, Myrvold HE, Pedersen SA, Liedman B, Hatlebakk JG, Julkonen R, Levander K, Carlsson J, Lamm M, Wiklund I (2001) Continued (5-year) followup of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease. J Am Coll Surg 192:172–179; discussion 179–181CrossRefPubMed
38.
Smith PM, Kerr GD, Cockel R, Ross BA, Bate CM, Brown P, Dronfield MW, Green JR, Hislop WS, Theodossi A, et al (1994) A comparison of omeprazole and ranitidine in the prevention of recurrence of benign esophageal stricture. Restore investigator group. Gastroenterology 107:1312–1318PubMed
39.
Perdikis G, Hinder RA, Filipi CJ, Walenz T, McBride PJ, Smith SL, Katada N, Klingler PJ (1997) Laparoscopic paraesophageal hernia repair. Arch Surg 132:586–589; discussion 590–591PubMed
40.
Luketich JD, Raja S, Fernando HC, Campbell W, Christie NA, Buenaventura PO, Weigel TL, Keenan RJ, Schauer PR (2000) Laparoscopic repair of giant paraesophageal hernia: 100 consecutive cases. Ann Surg 232:608–618CrossRefPubMed
41.
Bammer T, Hinder RA, Klaus A, Trastek VF, Achem SR (2001) Rationale for surgical therapy of Barrett esophagus. Mayo Clin Proc 76:335–342PubMed
42.
Hofstetter WL, Peters JH, DeMeester TR, Hagen JA, DeMeester SR, Crookes PF, Tsai P, Banki F, Bremner CG (2001) Long-term outcome of antireflux surgery in patients with Barrett’s esophagus. Ann Surg 234:532–538; discussion 538–539CrossRefPubMed
43.
Zaninotto G, Di Mario F, Costantini M, Baffa R, Germana B, Dal Santo PL, Rugge M, Bolzan M, Naccarato R, Ancona E (1992) Oesophagitis and pH of refluxate: an experimental and clinical study. Br J Surg 79:161–164PubMed
44.
Stein HJ, Feussner H, Kauer W, DeMeester TR, Siewert JR (1994) Alkaline gastroesophageal reflux: assessment by ambulatory esophageal aspiration and pH monitoring. Am J Surg 167:163–168CrossRefPubMed
45.
Kauer WK, Peters JH, DeMeester TR, Ireland AP, Bremner CG, Hagen JA (1995) Mixed reflux of gastric and duodenal juices is more harmful to the esophagus than gastric juice alone. The need for surgical therapy re-emphasized. Ann Surg 222:525–531; discussion 531–533PubMed
46.
Stein HJ, Feussner H, Siewert JR (1996) Failure of antireflux surgery: causes and management strategies. Am J Surg 171:36–39; discussion 39–40CrossRefPubMed
47.
Watson DI, Pike GK, Baigrie RJ, Mathew G, Devitt PG, Britten-Jones R, Jamieson GG (1997) Prospective double-blind randomized trial of laparoscopic Nissen fundoplication with division and without division of short gastric vessels. Ann Surg 226:642–652CrossRefPubMed
48.
O’Boyle CJ, Watson DI, Jamieson GG, Myers JC, Game PA, Devitt PG (2002) Division of short gastric vessels at laparoscopic Nissen fundoplication: a prospective double-blind randomized trial with 5-year follow-up. Ann Surg 235:165–170CrossRefPubMed
49.
Peters JH, DeMeester TR (1996) Indications, benefits and outcome of laparoscopic Nissen fundoplication. Dig Dis 14:169–179PubMed
50.
Cadiere GB, Houben JJ, Bruyns J, Himpens J, Panzer JM, Gelin M (1994) Laparoscopic Nissen fundoplication: technique and preliminary results. Br J Surg 81:400–403PubMed
51.
Hunter JG, Trus TL, Branum GD, Waring JP, Wood WC (1996) A physiologic approach to laparoscopic fundoplication for gastroesophageal reflux disease. Ann Surg 223:673–685; discussion 685–687CrossRefPubMed
52.
Granderath FA, Kamolz T, Schweiger UM, Pointner R (2003) Laparoscopic antireflux surgery for gastroesophageal reflux disease: experience with 668 laparoscopic antireflux procedures. Int J Colorectal Dis 18:73–77CrossRefPubMed
53.
Stein HJ, Bremner RM, Jamieson J, DeMeester TR (1992) Effect of Nissen fundoplication on esophageal motor function. Arch Surg 127:788–791
54.
Heider TR, Behrns KE, Koruda MJ, Shaheen NJ, Lucktong TA, Bradshaw B, Farrell TM (2003) Fundoplication improves disordered esophageal motility. J Gastrointest Surg 7:159–163CrossRefPubMed
55.
Zornig C, Strate U, Fibbe C, Emmermann A, Layer P (2002) Nissen vs Toupet laparoscopic fundoplication. Surg Endosc 16:758–766CrossRefPubMed
56.
Stein HJ, Eypasch EP, DeMeester TR, Smyrk TC, Attwood SE (1990) Circadian esophageal motor function in patients with gastroesophageal reflux disease. Surgery 108:769–777; discussion 777–778PubMed
57.
Belsey R (1995) The Mark IV antireflux procedure. Ann Chir Gynaecol 84:107–113PubMed
58.
Toupet A (1963) Technique d’oesophago-gastroplastie avec phréno-gastropexie appliquée dans la cure radicale des hernies hiatales et comme complément de l’opération de Heller dans les cardiospasmes. Academie de Chirurgie, pp 394–399
59.
Watson A, Jenkinson LR, Ball CS, Barlow AP, Norris TL (1991) A more physiological alternative to total fundoplication for the surgical correction of resistant gastro-oesophageal reflux. Br J Surg 78:1088–1094PubMed
60.
Thor KB, Silander T (1989) A long-term randomized prospective trial of the Nissen procedure versus a modified Toupet technique. Ann Surg 210:719–724PubMed
61.
Patti MG, De Pinto M, de Bellis M, Arcerito M, Tong J, Wang A, Mulvihill SJ, Way LW (1997) Comparison of laparoscopic total and partial fundoplication for gastroesophageal reflux. J Gastrointest Surg 1:309–315CrossRefPubMed
62.
Lundell L, Abrahamsson H, Ruth M, Rydberg L, Lonroth H, Olbe L (1996) Long-term results of a prospective randomized comparison of total fundic wrap (Nissen–Rossetti) or semifundoplication (Toupet) for gastro-oesophageal reflux. Br J Surg 83:830–835PubMed
63.
Fibbe C, Layer P, Keller J, Strate U, Emmermann A, Zornig C (2001) Esophageal motility in reflux disease before and after fundoplication: a prospective, randomized, clinical, and manometric study. Gastroenterology 121:5–14PubMed
64.
Farrell TM, Archer SB, Galloway KD, Branum GD, Smith CD, Hunter JG (2000) Heartburn is more likely to recur after Toupet fundoplication than Nissen fundoplication. Am Surg 66:229–236; discussion 236–237PubMed
65.
Fernando HC, Luketich JD, Christie NA, Ikramuddin S, Schauer PR (2002) Outcomes of laparoscopic Toupet compared to laparoscopic Nissen fundoplication. Surg Endosc 16:905–908CrossRefPubMed
66.
Glaser K, Wetscher GJ, Klingler A, Wieschemeyer T (1997) Die laparoskopische Toupet-Fundoplikation bei Refluxpatienten mit gestörter Ösophagusmotilität. Chir Gastroenterol 13:132–136
67.
Glaser K, Klingler A, Wetscher GJ, Eltschka B, Hollinsky CH, Klingler PJ, Achem SR, Hinder AR (2000) Selection of patients for laparoscopic antireflux surgery. Dig Dis 18:129–137CrossRefPubMed
Metadaten
Titel
The Nissen fundoplication: indication, technical aspects and postoperative outcome
verfasst von
H. Wykypiel
G. J. Wetscher
P. Klingler
K. Glaser
Publikationsdatum
01.11.2005
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 6/2005
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-004-0494-7

Weitere Artikel der Ausgabe 6/2005

Langenbeck's Archives of Surgery 6/2005 Zur Ausgabe

Original Article

Effect of increasing cardiac preload, sympathetic antagonism, or vasodilation on visceral blood flow during pneumoperitoneum

Original Article

Serum VEGF and b-FGF profiles after tension-free or conventional hernioplasty

Original Article

Impact of lateral pelvic lymph node dissection on evacuatory and urinary functions following low anterior resection for advanced rectal carcinoma

Original Article

LapSim virtual reality laparoscopic simulator reflects clinical experience in German surgeons

Mastery in Surgery

Professor Louis Francois Hollender

Original Article

Fecal incontinence: an up-to-date critical overview of surgical treatment options

Neu im Fachgebiet Chirurgie

23.04.2024 | Ablationstherapie | Nachrichten

Wie erfolgreich ist eine Re-Ablation nach Rezidiv?

23.04.2024 | Appendizitis | Nachrichten

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 | Operationsvorbereitung | Nachrichten

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

19.04.2024 | EAU 2024 | Kongressbericht | Nachrichten

Ureterstriktur: Innovative OP-Technik bewährt sich
weitere anzeigen

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Aktuelle BDC Leitlinien-Webinare

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.