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World J Surg. 2014 Apr;38(4):882-9. doi: 10.1007/s00268-013-2349-2.

Endoscopic evaluation of laparoscopic nissen fundoplication: 89 % success rate 10 years after surgery.

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1
Department of Surgery, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220, Seinäjoki, Finland.

Abstract

BACKGROUND:

The surgical outcome of fundoplication can be evaluated by means of esophagogastroduodenoscopy (EGDS). The literature reveals only one prior long-term follow-up series with endoscopic evaluation of the fundoplication wraps after laparoscopic Nissen fundoplication (LNF). The results achieved at a university clinic showed LNF to be more durable than open fundoplication (ONF). Previously, in our community-based hospital, the results of ONF were somewhat poorer than those achieved at a university clinic. The objective of the present study was to describe the long-term results of LNF in our hospital as regards surgical and symptomatic outcomes.

METHODS:

In 1997-1999, 107 LNFs were performed in our hospital. A questionnaire with symptom evaluation was mailed to all patients. The patients who agreed to participate were interviewed and underwent EGDS.

RESULTS:

Of the 107 patients, 64 (59.8 %) participated in the study (40 men, mean age 61.9 years, range 28-85 years). The mean follow-up time was 9.8 years. Seven endoscopic examinations (10.9 %) showed a defective fundic wrap; three of the patients had undergone reoperation. Fifty-eight (90.6 %) patients had no or minimal heartburn and 61 (95.3 %) had no or minimal regurgitation. Twenty-three (35.9 %) patients had moderate or severe dysphagia, and 43 (67.2 %) patients had moderate or severe flatulence. Fifty-seven (89.1 %) patients would have opted for surgery again.

CONCLUSIONS:

This study contributes to the previous notion that LNF is associated with fewer surgical failures than ONF. Our results indicate that LNF can well be performed in a community-based hospital with acceptable long-term results.

PMID:
24280977
DOI:
10.1007/s00268-013-2349-2
[Indexed for MEDLINE]

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