USF-LVHN SELECT
Postoperative Outcomes of Anti-Reflux Surgery in Lung Transplant Recipients.
Publication/Presentation Date
6-19-2025
Abstract
BACKGROUND: Gastroesophageal reflux disease (GERD) is a risk factor for aspiration and lung allograft rejection. Anti-reflux surgery (ARS) can be utilized for these patients to improve GERD and abate the decline of lung function. Accordingly, this study seeks to compare the efficacy of different accepted ARS techniques in lung transplant populations.
METHODS: A single-center retrospective cohort study of lung transplant recipients who underwent ARS between 2011 - 2023 was performed. GERD symptoms were based on proton-pump inhibitor (PPI) usage postoperatively. Pulmonary function testing, postoperative complications, dysphagia complaints, and endoscopic or surgical revisions were also evaluated and compared using Chi-square and Wilcoxon rank-sum tests. P≤0.05 denoted significance.
RESULTS: Ninety-six patients underwent Nissen (49.0%), Toupet (46.9%), or Dor (1.0%) fundoplication, or magnetic sphincter augmentation (MSA, 3.1%). Nissen fundoplication patients had increased rates of PPI usage at 3- (93% vs 54.8%, p< 0.001) and 6-months (90.7% vs 40.5%, p< 0.001) postoperatively with no significant differences at most recent follow up when compared with Toupet patients. Between Nissen and Toupet fundoplication patients, differences in rates of post-operative dysphagia (45.7% vs 42.2%, p=0.678), endoscopic dilation (17.4% vs 22.2%, p=0.219), and revisional surgery (8.7% vs 2.2%, p=0.140) were statistically insignificant. No significant differences in FEV1 (1.98L vs. 2.04L, p=0.470) or in median FEV1 percent change (1.96% vs. 0.98% respectively, p=0.524) pre- to post-ARS were identified when comparing Nissen vs. Toupet.
CONCLUSION: Considering lower PPI usage at 3- and 6- months post-ARS, Toupet fundoplication is superior to Nissen in decreasing PPI use in lung transplant recipients. Postoperative dysphagia, reintervention, and pulmonary function outcomes are similar between Toupet and Nissen patients.
First Page
102126
Last Page
102126
ISSN
1873-4626
Published In/Presented At
Parker, J., Doyle, W. N., Peddi, P., Stevens, M., Rogers, M., Mhaskar, R., Patel, K., & DuCoin, C. (2025). Postoperative Outcomes of Anti-Reflux Surgery in Lung Transplant Recipients. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 102126. Advance online publication. https://doi.org/10.1016/j.gassur.2025.102126
Disciplines
Medical Education | Medicine and Health Sciences
PubMedID
40543600
Department(s)
USF-LVHN SELECT Program, USF-LVHN SELECT Program Students
Document Type
Article