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Should abnormal oesophageal motility in gastro-oesophageal reflux disease (GORD) influence decisions about fundoplication?
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  1. R C Heading
  1. Centre for Liver and Digestive Disorders, Royal Infirmary, Edinburgh EH3 9YW, UK; R.Heading@ed.ac.uk

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Does abnormal oesophageal motility in gastro-oesophageal reflux disease affect the outcome of laparoscopic fundoplication?

Is it important to perform oesophageal function tests before surgery for gastro-oesophageal reflux disease (GORD)? For some years now, oesophageal manometry and a pH study have formed part of the “work up” of GORD patients being considered for fundoplication, supposedly (i) to ensure that the diagnosis of GORD is correct, (ii) to allow surgery to be “tailored”—a partial wrap fundoplication being performed in patients with especially poor oesophageal motility to minimise the risk of postoperative dysphagia,1–3 and (iii) to obtain preoperative data so that the success of treatment can be appraised from postoperative measurements in the same patient. As technology has advanced, the increasing complexity of manometry reports and 24 hour pH data have allowed impressively detailed documents from the oesophageal laboratory to be inserted into each patient's case notes but also raise some questions about whether all of these numbers really contribute to clinical decisions about antireflux surgery.

Background: The role of impaired oesophageal motility, which is found in up to 50% …

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