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The Nissen fundoplication: indication, technical aspects and postoperative outcome
H Wykypiel1, G J Wetscher, P Klingler
1Department of General and Transplantation Surgery, University Hospital of Innsbruck, Innsbruck, Austria.
Langenbeck'S Archives of Surgery
|September 8, 2004
Summary
Surgical intervention for gastroesophageal reflux disease (GERD) can effectively restore the anti-reflux barrier, improving quality of life and preventing esophageal cancer. Laparoscopic Nissen fundoplication offers good long-term results but may require alternative procedures for some patients.
Area of Science:
- Foregut disease management
- Surgical gastroenterology
Background:
- Gastroesophageal reflux disease (GERD) is a prevalent condition significantly impacting quality of life.
- GERD presents with diverse symptoms and carries risks, including esophageal carcinogenesis.
- Medical treatments for GERD can be ineffective due to complex pathophysiology.
Purpose of the Study:
- To evaluate the efficacy of surgical interventions for GERD.
- To present data on patient outcomes following anti-reflux surgery.
- To discuss the role of laparoscopic Nissen fundoplication and alternative procedures.
Main Methods:
- Comprehensive literature review.
- Analysis of clinical experience with over 4,000 evaluated patients.
- Inclusion of data from 382 patients who underwent anti-reflux surgery.
Main Results:
- Laparoscopic Nissen fundoplication is a widely adopted surgical technique for GERD.
- This procedure demonstrates favorable long-term outcomes for most patients.
- A subset of patients may experience side effects due to increased esophageal outflow resistance.
Conclusions:
- Surgery can effectively cure GERD by restoring the anti-reflux barrier.
- Laparoscopic Nissen fundoplication provides good long-term results but has potential side effects.
- Alternative anti-reflux procedures are valuable for selected GERD patients.