OGBN P29 Short term outcomes after anti-reflux surgery for Gastro-Oesophageal Reflux disease

Abstract

Abstract Background Laparoscopic fundoplication is the standard surgical practice for management of Gastro-oesophageal reflux Disease (GORD). However, post operative complications and recurrence can be problematic. We conducted this study to assess short-term post operative outcomes following anti-reflux surgery (ARS) for GORD at our UGI surgery unit at a busy District General Hospital (DGH). Methods All patients above 18 years of age undergoing ARS between January 2016 and December 2021 were included. We excluded patients who underwent fundoplication as part of treatment of achalasia or large hiatus hernia repairs. Data was collected retrospectively from a prospectively maintained database. Pre –operative investigations and surgical procedure was recorded. Primary outcome assessed were post-operative complications recorded as per Clavien-Dindo grade and re-operation rates. Secondary outcomes assessed were symptomatic relief and proton pump inhibitor (PPI) discontinuation. Results 86 patients were included. The median age at surgery was 52 years. 98% patients had typical symptoms of GORD at presentation. On pre-operative OGD, 29% patients had oesophagitis and 77.91% had hiatus hernia. 79 (91.86%) patients underwent pH manometry. 97.67% patients underwent Nissen fundoplication. All cases were successfully completed laparoscopically with no conversions to open. The median post-operative length of stay was 1 day. 93.02% had no post operative complications, and none had 30 day re-operation. At 1-year follow up, 97.67% patients reported improvement in symptoms and 94.19% patients were able to stop PPI use. Conclusions Laparoscopic fundoplication provides excellent relief of GORD symptoms with low incidence of post operative complications and re-operation rates.