Laparoscopic highly selective vagotomy with nissen fundoplication: is there any role?

INTRODUCTION

Nissen fundoplication (NF) has not been a uniformly successful treatment for gastroesophageal reflux disease (GERD). Acid lowering procedures such as highly selective vagotomy (HSV) have not yet been fully evaluated as an adjunctive treatment. NFHSV was evaluated in GERD.

MATERIALS AND

METHODS

Between June 2003 and June 2005, 8 women with a history of 6 months of GERD unrelieved by medication, preprandial pain, peptic ulcer disease, or severe gastritis underwent laparoscopic NFHSV. They have been followed for a mean 12 months. Preoperative and postoperative Heartburn Severity scores (HSS) were obtained.

RESULTS

Mean operative time was 110 minutes. There were no complications. One patient needed postoperative proton pump inhibitor, which was discontinued after smoking cessation 5 months after NFHSV. All 8 patients showed marked improvement in symptoms and HSS.

CONCLUSIONS

This series lends credence to the notion that NFHSV was effective. Several studies need to be performed to demonstrate the full efficacy and safety of this approach.