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Does laparoscopic Nissen fundoplication lead to chronic gastrointestinal dysfunction?
L Biertho1, H Sebajang, C Allen
1Centre for Minimal Access Surgery, McMaster University, 50 Charlton Ave E., Hamilton, Ontario, L8N 4A6, Canada.
Surgical Endoscopy
|July 11, 2006
Summary
Laparoscopic Nissen fundoplication (LNF) effectively treats GERD symptoms. While most patients experience relief from nonspecific gastrointestinal issues, a small percentage may develop new, though usually not clinically significant, GI complaints post-surgery.
Area of Science:
- Gastroenterology
- Surgical Procedures
- Patient Outcomes
Background:
- Gastroesophageal reflux disease (GERD) is commonly managed with Laparoscopic Nissen fundoplication (LNF).
- Nonspecific gastrointestinal (GI) symptoms have been anecdotally reported post-LNF.
- Long-term effects of LNF on these nonspecific GI complaints require further investigation.
Purpose of the Study:
- To assess the long-term impact of Laparoscopic Nissen fundoplication on nonspecific gastrointestinal symptoms.
- To evaluate the persistence and clinical significance of new GI complaints after LNF.
Main Methods:
- Prospective follow-up of 515 patients who underwent LNF between 1992 and 1998.
- Utilized a questionnaire to assess GERD and nonspecific GI symptoms (vomiting, diarrhea, constipation, appetite) pre- and post-surgery (6 months, 2, and 5 years).
Main Results:
- LNF significantly reduced both GERD and nonspecific GI symptoms scores in the overall patient cohort up to 5 years post-surgery (p < 0.001).
- Of patients with preoperative GI symptoms (69.7%), a significant reduction was observed post-LNF, lasting up to 5 years.
- A small, statistically significant increase in GI symptoms occurred in patients without preoperative symptoms (30.3%), but it was clinically significant (>12) in only 9.9%.
Conclusions:
- Laparoscopic Nissen fundoplication is an effective GERD treatment for up to 5 years.
- LNF is not associated with significant increases in nonspecific GI complaints for the majority of patients.
- While new nonspecific bowel symptoms can emerge post-LNF, they are typically not clinically significant.