The Impact of Nissen-Rossetti Fundoplication on the Perfusion in Microcirculation of the Gastric Fundus

• Authors: Stanisław Przywara , Grzegorz Wallner , Andrzej Dąbrowski , Tomasz Skoczylas , Jacek Wroński , Krzysztof Michalak , Robert Zymon
• Languages of publication: EN

Abstracts

EN

The aim of the study was to investigate the impact of Nissen-Rossetti fundoplication on the blood flow in the microcirculation of the gastric fundus.Material and methods. Eight patients undergoing Nissen-Rossetti fundoplication were included in the study. Perfusion in the gastric fundus was measured intraoperatively with laser Doppler flowmetry. An adhesive, flat, silicon probe was attached to the serosa in the same anatomical location during every measurement. Microcirculatory blood flow was recorded before and after fundoplication without ligation and division of the short gastric vessels.Results. In each patient, fundoplication led to increases in resting perfusion. Hyperperfusion was evoked by two mechanisms: increase in average blood flow and increase in vasomotion's amplitude and frequency.Conclusions. Fundoplication constitutes a new distribution of blood flow in the microcirculation of the gastric fundus, irrespective of its indication as a treatment of reflux disease or a supplement to cardiomyotomy in patients with achalasia. The procedure, when correctly performed, leads to local reactive hyperemia. Decreases in fundal perfusion suggest that the fundoplication wrap was created under excessive tension and may lead to dysphagia and local ischemia with consequences on motility of the lower esophagus. Thus, the assessment of change in perfusion of the gastric fundus after fundoplication might be a valuable tool in the routine quality control for appropriate performance of the fundoplication wrap.

Keywords

EN

fundoplication; microperfusion; gastric fundus; laser Doppler flowmetry

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2007
• Volume: 79
• Issue: 9
• Pages: 581-586

Dates

published

1 - 9 - 2007

online

11 - 2 - 2008

Contributors

author

Stanisław Przywara

author

Grzegorz Wallner

• Department of General Surgery, Prof. F. Skubiszewski Medical University, Lublin

author

Andrzej Dąbrowski

• Department of General Surgery, Prof. F. Skubiszewski Medical University, Lublin

author

Tomasz Skoczylas

• Department of General Surgery, Prof. F. Skubiszewski Medical University, Lublin

author

Jacek Wroński

• Department of Vascular Surgery and Angiology, Prof. F. Skubiszewski Medical University, Lublin

author

Krzysztof Michalak

• Department of Surgery, Public Hospital, Krasnystaw

author

Robert Zymon

• Department of Surgery, Pope John Paul the 2nd Public Hospital, Zamość

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Identifiers

DOI

10.2478/v10035-007-0091-x