Abstract
Treatment of gastroesophageal reflux disease (GERD) in the elderly follows the same principles as for any adult patient. The indication for laparoscopic antireflux surgery (LARS) often depends on the age of the patient. The aim of this prospective study was to evaluate the surgical outcome including quality of life after LARS and laparoscopic "redo-surgery" in patients older than 65 years. Since 1993, 75 patients with a mean age of 71 years have been treated with laparoscopic "floppy" Nissen (n = 53) or Toupet (n = 22) fundoplication. Thirteen patients underwent laparoscopic redo-surgery after failed LARS. Quality of life (GIQLI) was assessed before surgery and 3 months and 1 year after surgery, with 24-h pH monitoring and esophageal manometry being performed. Intraoperative complications occurred in two patients with primary LARS, successfully managed laparoscopically. The conversion and mortality rate was 0%. In two patients postoperative complications occurred. Three months and 1 year after surgery 24-h pH monitoring and esophageal manometry showed normal values in all patients. GIQLI increased significantly after surgery and is comparable to that of healthy individuals. One patient suffered from severe dysphagia and required dilatation. In 13 patients who underwent laparoscopic refundoplication, redo procedure was completed laparoscopically in 12 patients. In one patient conversion was necessary because of severe bleeding from the spleen. Data of esophageal manometry and 24-h pH monitoring showed normal values in all patients after redo-surgery. Three months and 1 year after laparoscopic reoperation the general score of GIQLI increased significantly (p < 0.01) and reached a level equivalent to that of comparable healthy individuals. Laparoscopic fundoplication and refundoplication in the elderly patient is a safe and effective treatment in GERD and improves quality of life significantly. Age should not be longer a contraindication to LARS.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
