RT Journal Article
SR Electronic
T1 Efficacy and safety of laparoscopic Toupet fundoplication surgery in lung transplant recipients
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P272
VO 44
IS Suppl 58
A1 Pauline Badrignans
A1 Olivier Risse
A1 Michele Fior-Gozlan
A1 Caroline De Traversay-Leroy
A1 Sebastien Quetant
A1 Christel Saint-Raymond
A1 Bruno Bonaz
A1 Jean Boutonnat
A1 Hubert Roth
A1 Christophe Pison
A1 Boubou Camara
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P272.abstract
AB Introduction: Fundoplication for gastro-esophageal reflux disease (GERD) may improve lung function and survival in lung transplant (LT) recipients, but morbidity and effects remain to be better reported.Methods: Data were collected between 2002 and 2013 in 25 consecutive LT recipients who underwent fundoplication. Esophageal Impedance, pH studies and lipophage index (LI) in BAL were conducted before and after surgery.Results: 25 LT recipients, 68% males, 44.9±16.6 years old, 11 cystic fibrosis, 6 COPD, 3 bronchiectasis, 2 pulmonary hypertension and 2 pulmonary fibrosis patients, had fundoplication for digestive symptoms of GERD (n=10, 40%), high LI in BAL (n=4, 16%), suspected cases of lung allograft dysfunction (n=7, 28%), and abnormal pH studies without digestive symptoms (n=4, 16%). Before surgery, 20/24 (83%) patients had pathological pH studies, 8/25 (32%) had abnormal impedance measurement and median [min-max] of LI in BAL was 9 [0-228]. Laparoscopic Toupet fundoplication was performed with 3 conversions in laparotomy. The median of hospital stay was 4 days [2-7]. After surgery, 0/22 patient had abnormal pH studies and 0/21 had abnormal impedance measurement. There was a significant improvement in reflux symptoms after surgery for all patients who had fundoplication for digestive symptoms. FEV1 increases from 2.57±0.99 L, 79.2±25.6% pred. to 2.82±0.98 L (p=0.0009) and 87.2±23.6% (p=0.002), BMI was unchanged and median of LI decreased from 9 to 8 [0-91] (p=0.59).Conclusion: Our results show that laparoscopic fundoplication for GERD is safe in LT recipients and significantly improve FEV1. Outcomes of LI in BAL need to be further studied after fundoplication.