Gastroesophageal reflux disease associated with poor esophageal body motility is effectively treated by laparoscopic toupet fundoplication

Summary Background The Nissen fundoplication, an effective treatment for gastroesophageal reflux disease (GERD), may frequently cause dysphagia in patients with poor esophageal body motility. Methods The laparoscopic Toupet fundoplication was performed in 24 patients with gastroesophageal reflux disease (GERD) with poor esophageal body motility of whom 18 (75%) presented with intermittent (n=16) or persistent (n=2) dysphagia for solids. Patients were followed-up for up to 12 months following surgery. Results Perioperative complications occurred in 4 patients (16.7%) including gastric perforation (n=1), intraabdominal hematoma (n=1), deep venous thrombosis of the calf (n=1) and pneumonia (n=1). There was no mortality and no conversion to open laparotomy among our patients 95.8% of patients were satisfied with surgery (Visick grade 1 or 2). Postoperatively 2 patients (8.4%) complained of dysphagia, one required reoperation due to too tight approximation of the hiatal crura. Conclusions The laparoscopic Toupet fundoplication is an effective treatment for GERD with poor esophageal body motility.