How useful is antireflux surgery in lung transplant patients with gastroesophageal reflux?
Materials and methods: A retrospective case series of lung transplant patients with reflux disease and Nissen fundoplication. Clinical symptoms, pH-metry data, use of PPIs were recorded before the procedure and up to 18 months postoperatively. The FEV1 values before and after Nissen fundoplication were recorded at 3 monthly intervals. Patients' satisfaction scores were recorded before operation and postoperatively.
Results: A total of 64 lung transplant patients were selected. After Nissen fundoplication, the pH studies were done on 26 patients. The mean overall acid exposure fraction was 1.03% (P < 0.05). FEV1 declined for 6 months postoperatively and then gradually improved. The comparison of FEV1 at 3 months preoperatively to 3 months postoperatively showed no significant difference (P = 0.067) as well as at 6 months. A significant improvement in clinical GERD symptoms was achieved after antireflux surgery; however, the patients remained receiving PPIs.
Conclusions: NF has been established as a safe operation for lung transplant patients. Late Nissen fundoplication did not improve lung function significantly amongst lung transplanted patients; however, patients with symptomatic GERD may have benefited from Nissen fundo- plication in terms of symptom relief. A multicenter randomized control trial is needed to assess the effect of early unselected reflux control on respiratory function and graft survival.
Pegna, V.; Mickevičius, A.; Tsang, C. How useful is antireflux surgery in lung transplant patients with gastroesophageal reflux? Medicina 2014, 50, 318-322.
Pegna V, Mickevičius A, Tsang C. How useful is antireflux surgery in lung transplant patients with gastroesophageal reflux? Medicina. 2014; 50(6):318-322.Chicago/Turabian Style
Pegna, Victoria; Mickevičius, Antanas; Tsang, Clement. 2014. "How useful is antireflux surgery in lung transplant patients with gastroesophageal reflux?" Medicina 50, no. 6: 318-322.