Abstract
PurposeNissen fundoplication (NF) is the most commonly used surgical treatment for persistent gastroesophageal reflux disease (GERD). We introduced to the alternative Thal fundoplication (TF) (partial anterior wrapping) in 1998. The purpose of this paper is to review and report on the effectiveness of TF in our department.MethodsWe retrospectively analyzed cases of 281 patients who underwent TF for GERD at our hospital from 1998 to 2019.ResultsAverage age, 16.3 ± 18.1 years; average body weight, 21.0 ± 16.0 kg; average operative time, 89.1 ± 43.0 min; average volume of bleeding, 11.6 ± 29.2 g; enteral feeding commenced after an average of 3.4 ± 1.3 postoperative days (PODs), and average postoperative full enteral feeding was 6.3 ± 1.4 PODs. Five patients (1.8%) had Clavien–Dindo classification III or higher; average hospital stay duration was 10.3 ± 6.0 days, with symptom recurrence affecting 17 patients (6.1%).ConclusionTF may be an effective and simple treatment for GERD that has few recurrences and avoids complications common to NF, but further studies to compare it with other techniques are needed.
Highlights
Gastroesophageal reflux (GER) is found physiologically in healthy people, especially during infancy, with symptoms often improving with age [1]
Once GER is associated with any additional symptoms or complications, it is defined as Gastroesophageal reflux disease (GERD)
Each Thal fundoplication (TF) surgery took an average of 89.1 ± 43.0 min, with an average of 11.6 ± 29.2 g of blood loss per patient
Summary
Gastroesophageal reflux (GER) is found physiologically in healthy people, especially during infancy, with symptoms often improving with age [1]. Once GER is associated with any additional symptoms or complications, it is defined as Gastroesophageal reflux disease (GERD). These complications range from esophagitis (resulting from refluxed gastric acid disturbing the esophageal mucosa), aspiration pneumonia (due to the influx of reflux into the trachea), asthma attacks to apnea (via the vagus reflex) amongst others. Such symptoms often promote the occurrence of other conditions [2]. We know that it is caused by transient relaxation of the LES lower, or, by a decrease in intra-abdominal pressure [4, 5]
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