{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T10:23:37Z","timestamp":1748946217624},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2011,1,20]],"date-time":"2011-01-20T00:00:00Z","timestamp":1295481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Laparoscopic Nissen fundoplication is the most frequently performed operation for gastro-oesophageal reflux disease (GORD). Studies on predictors of subjective outcome of fundoplication have yielded inconsistent results. This study identified predictors of objective reflux control after Nissen fundoplication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This was a retrospective analysis of prospectively collected data from patients who underwent Nissen fundoplication for proton pump inhibitor-refractory GORD with pathological acid exposure in a single centre between 1997 and 2005. The predictive value of demographics, endoscopic hiatal hernia size, oesophagitis, lower oesophageal sphincter pressure, distal oesophageal contraction amplitude, percentage of peristaltic contractions and acid exposure was determined. Endpoints were recurrent pathological acid exposure on 24-h pH monitoring at 6 months and surgical reintervention for recurrent GORD up to 6 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 177 patients, 22 had recurrent pathological acid exposure at 6 months for which 11 had surgery within 6 years. Only low percentage of peristaltic contractions (odds ratio (OR) 0\u00b797, 95 per cent confidence interval 0\u00b795 to 0\u00b799; P = 0\u00b7004) and high supine acid exposure (OR 1\u00b703, 1\u00b700 to 1\u00b707; P = 0\u00b7025) were independent predictors of recurrent pathological acid exposure. The absolute risk of recurrent exposure was 45\u00b75 per cent in patients with both predictors. High supine acid exposure was also an independent predictor of surgical reintervention (OR 1\u00b705, 1\u00b701 to 1\u00b708; P = 0\u00b7006).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Nissen fundoplication should not necessarily be withheld from patients with poor oesophageal peristalsis or excessive supine acid exposure. As about half of patients with both variables experience recurrent pathological acid exposure after primary Nissen fundoplication, surgery should be restricted in this group.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.7411","type":"journal-article","created":{"date-parts":[[2011,1,20]],"date-time":"2011-01-20T12:03:33Z","timestamp":1295525013000},"page":"673-679","source":"Crossref","is-referenced-by-count":22,"title":["Predictors of objectively identified recurrent reflux after primary Nissen fundoplication"],"prefix":"10.1093","volume":"98","author":[{"given":"J A J L","family":"Broeders","sequence":"first","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D J G H","family":"Roks","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W A","family":"Draaisma","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A L M","family":"Vlek","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E J","family":"Hazebroek","sequence":"additional","affiliation":[{"name":"Department of Surgery, Gastrointestinal Research Unit of the University Medical Center Utrecht, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I A M J","family":"Broeders","sequence":"additional","affiliation":[{"name":"Department of Surgery, Meander Medical Center, Amersfoort, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A J P M","family":"Smout","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Academic Medical Centre, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2011,1,20]]},"reference":[{"key":"2021070906345114400_bib1","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1136\/gut.2004.051821","article-title":"Epidemiology of gastro-oesophageal reflux disease: a systematic review","volume":"54","author":"Dent","year":"2005","journal-title":"Gut"},{"key":"2021070906345114400_bib2","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1097\/SLA.0b013e3181bcdaa7","article-title":"Ten-year outcome of laparoscopic and conventional Nissen fundoplication: randomized clinical trial","volume":"250","author":"Broeders","year":"2009","journal-title":"Ann Surg"},{"key":"2021070906345114400_bib3","first-page":"752","article-title":"Predictors of clinical outcomes following fundoplication for gastroesophageal reflux disease remain insufficiently defined: a systematic review","volume":"104","author":"Ip","year":"2009","journal-title":"Am J Gastroenterol"},{"key":"2021070906345114400_bib4","doi-asserted-by":"crossref","first-page":"2620","DOI":"10.1007\/s00268-009-0216-y","article-title":"Impact of gender and age on the long-term outcome of laparoscopic fundoplication","volume":"33","author":"Beck","year":"2009","journal-title":"World J Surg"},{"key":"2021070906345114400_bib5","doi-asserted-by":"crossref","first-page":"740","DOI":"10.3748\/wjg.v13.i5.740","article-title":"Influence of age on outcome of total laparoscopic fundoplication for gastroesophageal reflux disease","volume":"13","author":"Pizza","year":"2007","journal-title":"World J Gastroenterol"},{"key":"2021070906345114400_bib6","doi-asserted-by":"crossref","first-page":"1978","DOI":"10.1007\/s00464-007-9490-7","article-title":"Who will fail laparoscopic Nissen fundoplication? 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