The relation between Bougie size and postoperative complications in cases of fundoplication surgery

Abstract

ABSTRACT Background: Fundoplication is a surgical procedure used to treat stomach acid reflux. An effective length of fundoplication and bougie size has never been established in literature and it was mainly determined based on body weight or BMI. Aim of the study: Comparison between post-operative complications mainly dysphagia based on the size of bougie used during Nissen fundoplication for patients diagnosed with GERD. Material and Methods: Twenty patients were enrolled and randomized into two equal groups; group A “bougie size 40 French” and group B “bougie size 52 French”. Any perioperative related complications were documented and correlated to the size of bougie. Patients were seen in clinic 3 to 4 weeks after their operation for their postoperative check. All patient charts were reviewed for an upper endoscopy specifically for dysphagia and/or dilation within 6 months after surgery. Results: Patients in group (B) had nausea and heart burn recurrence more than group (A), patients in group (A) had gas bloating more than group (B) and each study group had the same number of patients who had vomiting without any significant difference between two study groups at any symptom. According to Eckardt score assessment pre- and post-operatively within two study groups it was less post than preoperatively with statistically significant difference. Conclusion: A performance of Nissen fundoplication with a bougie offers a safe and effective therapy for gastroesophageal reflux disease although there were no differences between different sizes of esophageal bougie regarding postoperative complications. It may provide low rates of long-term postoperative dysphagia and reflux recurrence.