Symptomatic outcome of laparoscopic fundoplication, using a minimal dissection technique

Area of Science:

• Gastroenterology
• Minimally Invasive Surgery
• Surgical Outcomes

Background:

• Gastro-oesophageal reflux disease (GORD) significantly impacts patient quality of life.
• Laparoscopic surgical techniques are increasingly utilized for GORD management.
• Assessing long-term symptomatic outcomes is crucial for evaluating surgical efficacy.

Purpose of the Study:

• To evaluate the symptomatic outcome of laparoscopic surgery for GORD using a minimal paraoesophageal dissection technique.
• To determine patient satisfaction and the persistence of benefits after the procedure.
• To identify any potential long-term sequelae associated with the surgical intervention.

Main Methods:

• A cohort of 135 consecutive patients undergoing laparoscopic surgery for GORD were included.
• A self-assessment questionnaire was administered at a median follow-up of 25 months.
• Data collected focused on reflux symptoms, medication use, patient satisfaction, and adverse events.

Main Results:

• 91% of patients reported improvement, with 87% free of reflux symptoms and 84% off medication.
• 90% reported persistent favorable outcomes, and 95% would recommend the procedure.
• 31% experienced dysphagia, and 76% reported gas bloating, impacting 24% of patients.

Conclusions:

• Laparoscopic fundoplication for GORD is a safe, fast procedure with minimal complications and high success rates.
• While effective in symptom control, the procedure can lead to persistent side effects such as dysphagia and gas bloating.
• The technique demonstrates a favorable risk-benefit profile, though patient counseling regarding potential sequelae is important.