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Functional outcome after laparoscopic or open Nissen fundoplication: a follow-up study
T K Rantanen1, J A Salo, J T Salminen
1Department of Surgery, Helsinki University Central Hospital, Finland.
Archives of Surgery (Chicago, Ill. : 1960)
|March 24, 1999
Summary
This study compared open and laparoscopic fundoplication for reflux esophagitis. Both methods showed similar long-term effectiveness, though laparoscopic surgery had more temporary dysphagia and less normal belching ability.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Reflux Management
Background:
- Gastroesophageal reflux disease (GERD) significantly impacts quality of life.
- Fundoplication is a common surgical treatment for GERD.
- Minimally invasive techniques like laparoscopic surgery are increasingly adopted.
Purpose of the Study:
- To compare the efficacy and functional outcomes of open versus laparoscopic fundoplication.
- To evaluate patient-reported symptoms and objective measures post-surgery.
Main Methods:
- A nonrandomized controlled study followed 57 patients with erosive reflux esophagitis for 3 years.
- Patients underwent either laparoscopic (30) or open (27) fundoplication.
- Outcomes assessed via interviews, postoperative endoscopy, and 24-hour esophageal pH monitoring.
Main Results:
- Temporary dysphagia was more frequent after laparoscopic fundoplication (67% vs 41%).
- Normal belching ability was significantly lower after laparoscopic surgery (40% vs 74%).
- Persistent dysphagia, reflux symptoms, bloating, and flatus were comparable between groups.
Conclusions:
- Both open and laparoscopic fundoplication offer comparable long-term functional outcomes for GERD.
- Laparoscopic approach is associated with more temporary dysphagia and impaired belching.
- Careful patient selection and surgical technique are crucial for optimal results.