Partial posterior wrap (toupet)in patients with defective esophageal body motility

The effectiveness of partial posterior wrap (Toupet procedure) in patients with defective esophageal body motility is controversial. To evaluate the effect of Toupet procedure upon the outcome of laparoscopic (LF) and open (OF) fundoplications in gastroesophageal reflux disease (GERD) patients with...

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Bibliographic Details
Published in:	Saudi journal of gastroenterology Vol. 11; no. 2; pp. 73 - 84
Main Authors:	El-Hak, Nabil Ali Gad, Zeid, Mostafa Abo, Aboelemen, Ahmed, Fouad, Amjad, Abd Alla, Talat, El Shoubary, Mohamed, Kandel, Tharout, Hamdy, Emad, Abdel Wahab, Mohamed, Fathy, Omar, El Ebidy, Gamal, Sultan, Ahmed, Elfiky, Amjad, Elghwalby, Nabih, Ezzat, Farouk
Format:	Journal Article
Language:	English
Published:	India Medknow Publications and Media Pvt. Ltd 01-05-2005 Wolters Kluwer Medknow Publications
Subjects:	Care and treatment defective body motility Evaluation Fundoplication Gastroesophageal reflux Partial posterior wrap Patient outcomes Toupet procedure Saudi Arabia
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Summary:	The effectiveness of partial posterior wrap (Toupet procedure) in patients with defective esophageal body motility is controversial. To evaluate the effect of Toupet procedure upon the outcome of laparoscopic (LF) and open (OF) fundoplications in gastroesophageal reflux disease (GERD) patients with defective esophageal body motility. This study included 32 patients with severe GERD who underwent Toupet procedure; 18 (56.25%) OF 'and 14 (43.75%) LF. Outcome measures included assessment of relief of the symptoms, results of repeated endoscopy, barium study, manometry and pH metry; both early (within six months) and late (two years at least). Relief of heartburn was achieved in 26 patients (81.3%). These include 14 (77.7%) and 12 (85.7%) patients who underwent OF and LF respectively. Occasional dysphagia developed in six patients (18.7%) early, and three (9.4%) late; all were managed conservatively. Endoscopic esophagitis healed in 26 patients (81.3%); 14 (77.7%) OF and 12 (85.7%) LF. Mean LES and body pressures improved (10.5 to 17.7 and 29.0 to 41.0 mmHg respectively). Persistent acid reflux was detected in six patients (18.7%); two (22.3%) OF and two (14.3%) LF. Toupet fundoplication is an effective procedure for reflux control except in patients with severe GERD.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1319-3767 1998-4049
DOI:	10.4103/1319-3767.33323