Long-term symptomatic follow-up after lind fundoplication

Area of Science:

• Gastroenterology
• Surgical Oncology
• Digestive System Diseases

Background:

• Limited long-term data exists for antireflux surgery outcomes.
• Gastro-oesophageal reflux disease (GERD) significantly impacts patient quality of life.
• Assessing the durability of surgical interventions is crucial for patient management.

Purpose of the Study:

• To evaluate the long-term efficacy of open Lind fundoplication for GERD symptom control.
• To establish a benchmark for comparing outcomes with newer laparoscopic techniques.

Main Methods:

• A cohort of 132 patients underwent primary open Lind fundoplication between 1986 and 1994.
• Oesophageal pH monitoring was performed pre- and post-operatively in 91 patients.
• Long-term symptom assessment was conducted via telephone interview at a median of 9.5 years post-surgery in 112 surviving patients.

Main Results:

• Open Lind fundoplication significantly reduced oesophageal acid exposure (14.9% to 2.4%, P < 0.001).
• At long-term follow-up, 95% of patients were symptom-free of heartburn and regurgitation.
• 33% experienced early post-fundoplication symptoms; 3% had persistent dysphagia or gas bloat.

Conclusions:

• Open Lind fundoplication demonstrates high long-term effectiveness (95%) in managing GERD.
• The procedure offers durable symptom control, with minimal persistent complications.
• Results provide a critical standard for evaluating the long-term success of laparoscopic antireflux surgery.