Trial reportJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2013
Length and pressure of the reconstructed lower esophageal sphincter is determined by both crural closure and Nissen fundoplication.
Trial report in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 50 citations in OpenAlex.
- Comparative study between the effect of Nissen fundoplication and Toupet fundoplication on postoperative manometry findings. A randomized control trial study.Surgical endoscopy · 2025Trial
- Factors influencing the outcome of magnetic sphincter augmentation for chronic gastroesophageal reflux disease.Surgical endoscopy · 2018Trial
- A Historical and Scientific Review of Anti-Reflux Surgery: Evolution, Evidence, and Future Directions.Current gastroenterology reports · 2026Review
- The failure pattern for the magnetic sphincter augmentation device: a single-institution case series with literature review.Surgical endoscopy · 2025Review
- Cruroplasty as a standalone treatment for recurrent hiatal hernia repair.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Fundoplication: Old Concept for Novel Challenges?Visceral medicine · 2024Review
- Longer-term outcomes of gastroesophageal reflux disease treated with magnetic sphincter augmentation.Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus · 2023Article
- Safety profile of magnetic sphincter augmentation for gastroesophageal reflux disease.Frontiers in surgery · 2023Article
- Crural closure, not fundoplication, results in a significant decrease in lower esophageal sphincter distensibility.Surgical endoscopy · 2022Article
- Endoscopic anti-reflux therapy for gastroesophageal reflux disease.World journal of gastroenterology · 2021Review
- Reference high-resolution manometry values after magnetic sphincter augmentation.Neurogastroenterology and motility · 2021Article
- Less is more: cruroplasty alone is sufficient for revisional hiatal hernia surgery.Surgical endoscopy · 2021Article
- Does Treatment of the Hiatus Influence the Outcomes of Magnetic Sphincter Augmentation for Chronic GERD?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019Article
- Minimal versus obligatory dissection of the diaphragmatic hiatus during magnetic sphincter augmentation surgery.Surgical endoscopy · 2019Article
- Hiatal hernia recurrence following magnetic sphincter augmentation and posterior cruroplasty: intermediate-term outcomes.Surgical endoscopy · 2018Article
- Crural Closure improves Outcomes of Magnetic Sphincter Augmentation in GERD patients with Hiatal Hernia.Scientific reports · 2018Article
- Favorable results from a prospective evaluation of 200 patients with large hiatal hernias undergoing LINX magnetic sphincter augmentation.Surgical endoscopy · 2018Article
- Efficacy of magnetic sphincter augmentation in patients with large hiatal hernias.Surgical endoscopy · 2017Article
- [Antireflux operations: indications and techniques].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2013Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic Nissen fundoplication is comprised of: a wrap thought responsible for the lower esophageal sphincter function and crural closure performed to prevent herniation. We hypothesized gastroesophageal junction competence effected by Nissen fundoplication results from closure of the crural diaphragm and creation of the fundoplication.
methodsPatients with uncomplicated reflux undergoing Nissen fundoplication were prospectively enrolled. After hiatal dissection, patients were randomized to crural closure followed by fundoplication (group 1) or fundoplication followed by crural closure (group 2). Intra-operative high-resolution manometry collected sphincter pressure and length data after complete dissection and after each component repair.
resultsEighteen patients were randomized. When compared to the completely dissected hiatus, the mean sphincter length increased 1.3 cm (p < 0.001), and mean sphincter pressure was increased by 13.7 mmHg (p < 0.001). Groups 1 and 2 had similar sphincter length and pressure changes. Crural closure and fundal wrap contribute equally to sphincter length, although crural closure appears to contribute more to sphincter pressure.
conclusionThe Nissen fundoplication restores the function of the gastroesophageal junction and thus the reflux barrier by means of two main components: the crural closure and the construction of a 360° fundal wrap. Each of these components is equally important in establishing both increased sphincter length and pressure.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.