Supplementary Material for: Effect of Laparoscopic Antireflux Surgery on Esophageal Motility

Background/Aims: The effect of laparoscopic antireflux
surgery on esophageal motility is incompletely understood, and any
indication for this procedure in patients with motility disorder is
disputed in literature. We evaluated the influence of laparoscopic
Nissen fundoplication on impaired esophageal motility. Methods:
In this pathological manometric study, we divided the patients into two
groups preoperatively: the hypomotility group (mean amplitude of
esophageal contraction wave <40 mm Hg; HYPO group, n = 11) and the
normal group (mean amplitude of esophageal contraction wave >40 mm
Hg; NORM group, n = 43). The amplitudes of esophageal contraction waves 3
and 8 cm above the lower esophageal sphincter and the percentage of
peristaltic contraction waves of the tubular esophagus were analyzed
pre- and postoperatively. Results: In total, 54 patients
with GERD underwent esophageal manometry before and 6 months after
Nissen fundoplication. The length and pressure of the lower esophageal
sphincter were increased in both groups postoperatively (p < 0.01).
Patients in the HYPO group (n = 11) showed a statistically significant
increase of mean amplitude of esophageal contraction (32.8 vs. 57.3 mm
Hg; p < 0.01), while no change was found in the NORM group (n = 43). A
total of 72% of patients with preoperative motility disorder showed
normal postoperative manometry. Conclusion: Nissen
fundoplication normalizes esophageal motility, especially in patients
with preoperative hypomotility. Patients with impaired esophageal
motility should not per se be excluded from antireflux surgery.