{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:27:56Z","timestamp":1767652076699},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2001,4,1]],"date-time":"2001-04-01T00:00:00Z","timestamp":986083200000},"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":[[2001,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>After Nissen fundoplication, troublesome dysphagia develops in 5\u201310 per cent of patients. The mechanism of dysphagia has not been fully resolved, in spite of a number of studies focusing on oesophageal motility and lower oesophageal sphincter (LOS) dynamics. Tightness and length of the wrap have had considerable attention, without giving a fully satisfactory explanation of the pathophysiological mechanism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Eighteen patients with persistent dysphagia after Nissen fundoplication needing reoperation were studied. Eighteen patients, matched for age and sex, without dysphagia after Nissen fundoplication were used as controls. Reoperation consisted of conversion of a 360\u00b0 into a 270\u00b0 wrap. Barium swallow, endoscopy, oesophageal manometry and 24-h pH monitoring were performed before and after (re)operation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Peristaltic amplitude, velocity and duration of contraction were not significantly influenced by operation. In 16 of 18 patients with dysphagia, LOS relaxation was incomplete and the residual relaxation pressure was significantly higher than that in the group without dysphagia (P &amp;lt; 0\u00b701). No correlation was found between LOS pressure and peristaltic amplitude, nor between LOS pressure and ramp pressure in the distal oesophagus. After reoperation, basal LOS pressure decreased significantly (P &amp;lt; 0\u00b701) and LOS relaxation was complete in all but three patients; residual relaxation pressure decreased (P &amp;lt; 0\u00b701) and was significantly lower than that after uncomplicated Nissen fundoplication. In the latter group, LOS pressure, residual relaxation pressure and ramp pressure increased significantly after operation (P &amp;lt; 0\u00b701).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A return to complete LOS relaxation and a decrease in residual relaxation pressure play an important role in resolving dysphagia.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1046\/j.1365-2168.2001.01724.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T07:22:30Z","timestamp":1047367350000},"page":"569-576","source":"Crossref","is-referenced-by-count":27,"title":["Analysis and surgical treatment of persistent dysphagia after Nissen fundoplication"],"prefix":"10.1093","volume":"88","author":[{"given":"J E","family":"Bais","sequence":"first","affiliation":[{"name":"Gastrointestinal Research Unit, University Medical Center Utrecht , Utrecht,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B P L","family":"Wijnhoven","sequence":"additional","affiliation":[{"name":"Gastrointestinal Research Unit, University Medical Center Utrecht , Utrecht,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A A M","family":"Masclee","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Leiden University Medical Center , Leiden,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A J P M","family":"Smout","sequence":"additional","affiliation":[{"name":"Gastrointestinal Research Unit, University Medical Center Utrecht , Utrecht,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H G","family":"Gooszen","sequence":"additional","affiliation":[{"name":"Gastrointestinal Research Unit, University Medical Center Utrecht , Utrecht,","place":["The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2001,4,1]]},"reference":[{"key":"2024093006061205400_bib1","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1136\/gut.34.8.1015","article-title":"Fate of Nissen fundoplication after 20 years. A clinical, endoscopical, and functional analysis","volume":"34","author":"Luostarinen","year":"1993","journal-title":"Gut"},{"key":"2024093006061205400_bib2","first-page":"357","article-title":"Long term results after Nissen fundoplication and Belsey Mark IV operation in patients with reflux oesophagitis and stricture","volume":"158","author":"Vollan","year":"1992","journal-title":"Eur J Surg"},{"key":"2024093006061205400_bib3","first-page":"115","article-title":"Nissen fundoplication for gastro-oesophageal reflux disease: long-term results","volume":"84","author":"Luostarinen","year":"1995","journal-title":"Ann Chir Gynaecol"},{"key":"2024093006061205400_bib4","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1001\/archsurg.1985.01390300013002","article-title":"The floppy Nissen fundoplication. Effective long-term control of pathologic reflux","volume":"120","author":"Donahue","year":"1985","journal-title":"Arch Surg"},{"key":"2024093006061205400_bib5","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/S0002-9610(99)80070-1","article-title":"Failure of antireflux surgery: causes and management strategies","volume":"171","author":"Stein","year":"1996","journal-title":"Am J Surg"},{"key":"2024093006061205400_bib6","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/BF02071542","article-title":"Minimizing the side effects of antireflux surgery","volume":"16","author":"DeMeester","year":"1992","journal-title":"World J Surg"},{"key":"2024093006061205400_bib7","first-page":"391","article-title":"Surgery for gastro-oesophageal reflux disease: laparoscopic versus traditional approach","volume":"29","author":"Stein","year":"1997","journal-title":"Ital J Gastroenterol Hepatol"},{"key":"2024093006061205400_bib8","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/S0002-9610(05)80120-5","article-title":"Successful management of severe gastroesophageal reflux disease with laparoscopic Nissen fundoplication","volume":"168","author":"Pitcher","year":"1994","journal-title":"Am J Surg"},{"key":"2024093006061205400_bib9","first-page":"646","article-title":"Laparoscopic Nissen fundoplication and postoperative dysphagia\u2014can it be predicted?","volume":"25","author":"Gotley","year":"1996","journal-title":"Ann Acad Med Singapore"},{"key":"2024093006061205400_bib10","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1002\/bjs.1800770115","article-title":"Oesophageal manometry and pH recording does not predict the bad results of Nissen fundoplication","volume":"77","author":"Mughal","year":"1990","journal-title":"Br J Surg"},{"key":"2024093006061205400_bib11","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s002689900280","article-title":"Tailored antireflux surgery for gastroesophageal reflux disease: effectiveness and risk of postoperative dysphagia","volume":"21","author":"Wetscher","year":"1997","journal-title":"World J Surg"},{"key":"2024093006061205400_bib12","first-page":"103","article-title":"Gastro-oesophageal reflux and oesophageal motility diseases. Who should perform antireflux surgery?","volume":"84","author":"Little","year":"1995","journal-title":"Ann Chir Gynaecol"},{"key":"2024093006061205400_bib13","doi-asserted-by":"crossref","first-page":"725","DOI":"10.3109\/00365529309098281","article-title":"The effect of antireflux operations on lower oesophageal sphincter tone and postprandial symptoms","volume":"28","author":"Lundell","year":"1993","journal-title":"Scand J Gastroenterol"},{"key":"2024093006061205400_bib14","first-page":"241","article-title":"Excessive competence of the lower oesophageal sphincter after Nissen fundoplication: evaluation by three-dimensional computerised imaging","volume":"161","author":"Zaninotto","year":"1995","journal-title":"Eur J Surg"},{"key":"2024093006061205400_bib15","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1007\/s004649900695","article-title":"Esophageal and lower esophageal sphincter pressure profiles 6 and 24 months after laparoscopic fundoplication and their association with postoperative dysphagia","volume":"12","author":"Anvari","year":"1998","journal-title":"Surg Endosc"},{"key":"2024093006061205400_bib16","first-page":"608","article-title":"The effect of floppy Nissen fundoplication on esophageal and gastric motility in gastroesophageal reflux","volume":"177","author":"Vassilakis","year":"1993","journal-title":"Surg Gynecol Obstet"},{"key":"2024093006061205400_bib17","doi-asserted-by":"crossref","first-page":"247","DOI":"10.1093\/dote\/10.4.247","article-title":"A prospective study of the effect of fundoplication on primary and secondary peristalsis in the esophagus","volume":"10","author":"Tew","year":"1997","journal-title":"Dis Esophagus"},{"key":"2024093006061205400_bib18","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1016\/0016-5085(86)90570-6","article-title":"Esophageal motor abnormalities in gastroesophageal reflux and the effects of fundoplication","volume":"91","author":"Gill","year":"1986","journal-title":"Gastroenterology"},{"key":"2024093006061205400_bib19","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1046\/j.1365-2168.1998.00832.x","article-title":"Oesophageal dysmotility is not associated with poor outcome after laparoscopic Nissen fundoplication","volume":"85","author":"Beckingham","year":"1998","journal-title":"Br J Surg"},{"key":"2024093006061205400_bib20","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1016\/S0022-5223(94)70044-3","article-title":"The effect of symptoms and nonspecific motility abnormalities on outcome of surgical therapy for gastroesophageal reflux disease","volume":"107","author":"Bremner","year":"1994","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2024093006061205400_bib21","doi-asserted-by":"crossref","first-page":"82","DOI":"10.3109\/00365528809096289","article-title":"Esophageal body motor disturbances in gastroesophageal reflux and the effects of fundoplication","volume":"155","author":"Johansson","year":"1988","journal-title":"Scand J Gastroenterol Suppl."},{"key":"2024093006061205400_bib22","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1097\/00000658-198911000-00003","article-title":"Belsey and Nissen operations for gastroesophageal reflux","volume":"210","author":"Stipa","year":"1989","journal-title":"Ann Surg"},{"key":"2024093006061205400_bib23","first-page":"585","article-title":"The Belsey Mark IV antireflux procedure: indications and long-term results","volume":"53","author":"Lerut","year":"1990","journal-title":"Acta Gastroenterol Belg"},{"key":"2024093006061205400_bib24","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1136\/gut.35.11.1529","article-title":"Prospective evaluation of 24 hour ambulatory pH metry in Belsey Mark IV antireflux surgery","volume":"35","author":"Horbach","year":"1994","journal-title":"Gut"},{"key":"2024093006061205400_bib25","first-page":"135","volume-title":"The Oesophagus: Handbook and Atlas of Endoscopy","author":"Savary","year":"1978"},{"key":"2024093006061205400_bib26","first-page":"G208","article-title":"Modulation of feline esophageal contractions by bolus Volume and outflow obstruction","volume":"258","author":"Mittal","year":"1990","journal-title":"Am J Physiol"},{"key":"2024093006061205400_bib27","first-page":"1465","article-title":"Oesophageal motility before and after laparoscopic Nissen fundoplication","volume":"84","author":"Mathew","year":"1997","journal-title":"Br J Surg"},{"volume-title":"Esophageal Motility Testing","year":"1994","author":"Castell","key":"2024093006061205400_bib28"},{"key":"2024093006061205400_bib29","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/00365521.1990.12067095","article-title":"Ambulatory 24-hour pH-metry in the diagnosis of gastroesophageal reflux disease. Determination of criteria and relation to endoscopy","volume":"25","author":"Masclee","year":"1990","journal-title":"Scand J Gastroenterol"},{"key":"2024093006061205400_bib30","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/0002-9610(79)90008-4","article-title":"Clinical and in vitro analysis of determinants of gastroesophageal competence. A study on the principles of antireflux surgery","volume":"137","author":"DeMeester","year":"1979","journal-title":"Am J Surg"},{"key":"2024093006061205400_bib31","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/S0140-6736(99)03097-4","article-title":"Laparoscopic or conventional Nissen fundoplication for gastro-oesophageal reflux disease: randomised clinical trial","volume":"355","author":"Bais","year":"2000","journal-title":"Lancet"},{"key":"2024093006061205400_bib32","first-page":"686","article-title":"Effect of fundoplication on transient lower oesophageal sphincter relaxation and gas reflux","volume":"84","author":"Johnsson","year":"1999","journal-title":"Br J Surg"},{"key":"2024093006061205400_bib33","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1046\/j.1365-2168.1999.00969.x","article-title":"Prospective randomized double-blind trial between laparoscopic Nissen fundoplication and anterior partial fundoplication","volume":"86","author":"Watson","year":"1999","journal-title":"Br J Surg"},{"key":"2024093006061205400_bib34","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1097\/00000658-199607000-00008","article-title":"Dysphagia after laparoscopic antireflux surgery. The impact of operative technique","volume":"224","author":"Hunter","year":"1996","journal-title":"Ann Surg"},{"key":"2024093006061205400_bib35","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1002\/bjs.1800830633","article-title":"Long-term results of a prospective randomized comparison of total fundic wrap (Nissen\u2013Rossetti) or semifundoplication (Toupet) for gastro-oesophageal reflux","volume":"83","author":"Lundell","year":"1996","journal-title":"Br J Surg"},{"key":"2024093006061205400_bib36","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/BF02090213","article-title":"A prospective study of effects of Belsey MK IV antireflux surgery on endoscopic esophagitis, lower esophageal sphincter pressure, and 24-hr pH measurements. Relation to symptom improvement","volume":"39","author":"Horbach","year":"1994","journal-title":"Dig Dis Sci"},{"key":"2024093006061205400_bib37","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/0002-9610(83)90301-X","article-title":"Nissen fundoplication. Results at 10 year follow-up","volume":"146","author":"Negre","year":"1983","journal-title":"Am J Surg"},{"key":"2024093006061205400_bib38","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1007\/BF01565918","article-title":"Complications of surgery for gastroesophageal reflux","volume":"1","author":"Skinner","year":"1977","journal-title":"World J Surg"},{"key":"2024093006061205400_bib39","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1001\/archsurg.1992.01420070040010","article-title":"Effect of Nissen fundoplication on esophageal motor function","volume":"127","author":"Stein","year":"1992","journal-title":"Arch Surg"},{"key":"2024093006061205400_bib40","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1136\/gut.40.3.381","article-title":"Outcome of laparoscopic Nissen fundoplication in patients with disordered preoperative peristalsis","volume":"40","author":"Baigrie","year":"1997","journal-title":"Gut"},{"key":"2024093006061205400_bib41","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1111\/j.1572-0241.2000.01760.x","article-title":"Predictability of dysphagia after laparoscopic Nissen fundoplication","volume":"95","author":"Kamolz","year":"2000","journal-title":"Am J Gastroenterol"},{"key":"2024093006061205400_bib42","first-page":"2318","article-title":"Evaluation and management of postfundoplication dysphagia","volume":"91","author":"Wo","year":"1996","journal-title":"Am J Gastroenterol"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.1365-2168.2001.01724.x","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1046%2Fj.1365-2168.2001.01724.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/88\/4\/569\/59441079\/bjs263.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/88\/4\/569\/59441079\/bjs263.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T06:09:04Z","timestamp":1727676544000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/88\/4\/569\/6268034"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,4,1]]},"references-count":42,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2001,4,1]]},"published-print":{"date-parts":[[2001,4,1]]}},"URL":"https:\/\/doi.org\/10.1046\/j.1365-2168.2001.01724.x","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"type":"print","value":"0007-1323"},{"type":"electronic","value":"1365-2168"}],"subject":[],"published-other":{"date-parts":[[2001,4]]},"published":{"date-parts":[[2001,4,1]]}}}