Fundoplication for laryngopharyngeal reflux despite preoperative dysphagia

Abstract

INTRODUCTIONFundoplication for laryngopharyngeal disease with oesophageal dysmotility has led to mixed outcomes. In the presence of preoperative dysphagia and oesophageal dysmotility, this procedure has engendered concern in certain regards.METHODSThis paper describes a consecutive series of laryngopharyngeal reflux (LPR) patients with a high frequency of dysmotility. Patients were selected for surgery with 24-hour dual channel pH monitoring, oesophageal manometry and standardised reflux scintigraphy.RESULTSFollowing careful patient selection, 33 patients underwent fundoplication by laparoscopy. Surgery had high efficacy in symptom control and there was no adverse dysphagia.CONCLUSIONSEvidence of proximal reflux can select a group of patients for good results of fundoplication for atypical symptoms.