Laproscopic Fundoplication for Gastro-Esophageal Reflux Disease

Abstract

Hypothesis Laproscopic Nissen Fundoplication provides long-term relief of symptoms of gastro-esophageal reflux disease. Patients From November 2006 to March 2009, we performed more than 140 laparoscopic antireflux procedures. The outcome for patients who underwent surgery between November 2006 and October 2009 (108 cases) was determined. This included all patients having laparoscopic Nissen fundoplication, from the first procedure onward. Interventions Long-term follow-up for 2 or more years after laparoscopic Nissen fundoplication was obtained. Results Outcome data covering a period of 2 or more years after surgery was available for 108 patients (95%), with 6 patients lost to follow-up. Two patients died (unrelated causes) at some stage following surgery, and the outcome was difficult to determine in 1 patient with cerebral palsy. Hence, questionnaire data were available for 99 patients at a median follow-up of 1.6 years (range, 1–3.4 years). 87% of the 99 patients remained free of significant reflux. Reoperation was required for dysphagia in 2 patients (2%), 1 for a tight wrap and 1 for a tight diaphragmatic hiatus. In addition, reoperation was necessary for a paraesophageal hiatus hernia in 1 patient (1%). Of the reoperations, 50% were performed within 12 months of the original procedure, and 50% during the second year of follow-up. The long-term outcome was considered “good or excellent” by 90% of patients. Conclusions The short-term outcome of laparoscopic Nissen fundoplication is “good or excellent” with most of the patients are free from drugs / diet change / life-style change.