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Laparoscopic Nissen fundoplication: five-year results and beyond
T Lafullarde1, D I Watson, G G Jamieson
1University of Adelaide Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia. david.watson@adelaide.edu.au
Archives of Surgery (Chicago, Ill. : 1960)
|February 15, 2001
Summary
Laparoscopic Nissen fundoplication offers long-term relief for gastroesophageal reflux disease symptoms. Most patients (90%) reported good or excellent outcomes, with 87% remaining free of significant reflux after a median of 6 years.
Area of Science:
- Gastroenterology and Surgical Innovation
Background:
- Gastroesophageal reflux disease (GERD) significantly impacts patient quality of life.
- Surgical interventions aim to provide durable symptom relief.
Purpose of the Study:
- To evaluate the long-term efficacy and outcomes of laparoscopic Nissen fundoplication for GERD.
- To assess patient satisfaction and complication rates following the procedure.
Main Methods:
- A prospective case series of 178 patients undergoing laparoscopic Nissen fundoplication between September 1991 and June 1994.
- Long-term follow-up (≥5 years) was conducted via structured interviews by an independent investigator.
Main Results:
- Outcome data available for 176 patients (99%) at a median follow-up of 6 years.
- 87% of patients remained free of significant reflux; 90% reported good or excellent long-term outcomes.
- Reoperation rates were 1.7% for recurrent reflux, 3.9% for dysphagia, and 7.3% for paraesophageal hiatus hernia, with most occurring within 2 years post-surgery.
Conclusions:
- Laparoscopic Nissen fundoplication demonstrates comparable long-term outcomes to open procedures.
- The procedure provides good to excellent long-term results for the majority of GERD patients.