[Results of laparoscopic antireflux surgery at five years and beyond]

Laparoscopic antireflux surgery was first introduced in 1991. As with any new technique, there was a learning curve during which surgeons had a unique opportunity to prospectively document the evolution of the technique and its results. We have regularly assessed our results and conducted randomised prospective studies with the aim of obtaining solid long-term outcome data. We now have at least 5 years of follow-up for two groups of patients. Group I consists of the first 178 patients who underwent fundoplicature, i.e. during the learning curve. Group II consists of 107 patients who were enrolled in a randomised trial comparing total fundoplicature with anterior partial fundoplication. The re-operation rate was 15% in Group I and only 6% in Group II. Overall, about 85% of patients were free of reflux symptoms 5-8 years after fundoplication, indicating that laparoscopic surgery provides a durable benefit in the vast majority of patients.