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Related Experiment Videos

Open vs laparoscopic partial posterior fundoplication. A prospective randomized trial.

B S Håkanson1, K B A Thor, A Thorell

  • 1Center for Gastrointestinal Disease, Ersta Hospital and Karolinska Institutet, Huddinge, Sweden. bengt.hakanson@erstadiakoni.se

Surgical Endoscopy
|November 24, 2006
PubMed
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Laparoscopic partial posterior fundoplication for gastroesophageal reflux disease (GERD) offers fewer complications and shorter recovery than open surgery. Long-term outcomes are comparable, making laparoscopy the preferred surgical option for GERD.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Comparative Effectiveness Research

Background:

  • Gastroesophageal reflux disease (GERD) significantly impacts patient quality of life.
  • Surgical interventions like partial posterior fundoplication aim to manage refractory GERD.
  • Open and laparoscopic approaches present distinct perioperative and long-term outcome profiles.

Purpose of the Study:

  • To compare the outcomes of open versus laparoscopic partial posterior fundoplication for GERD.
  • To evaluate perioperative course, complications, symptomatic relief, and recurrence rates.
  • To assess the need for reinterventional surgery in both surgical groups.

Main Methods:

  • Prospective randomized trial involving 192 patients (93 open, 99 laparoscopic).

Related Experiment Videos

  • Pre- and postoperative assessments included endoscopy, esophageal function tests, and clinical evaluations.
  • Patients were followed for a three-year period.

    • Main Results:

    • The open surgery group experienced higher complication rates, longer length of stay, and extended time off work.
    • The laparoscopic group had more early side effects and recurrences, with 8 patients requiring reoperation for recurrence versus 1 in the open group.
    • No significant differences were observed in patient-assessed satisfactory outcomes or reflux control at one and three years between the groups.

    Conclusions:

    • Laparoscopic partial posterior fundoplication demonstrates fewer general complications and shorter recovery periods compared to open surgery.
    • The need for reoperations and long-term outcomes (3 years) are comparable between the two surgical approaches.
    • Laparoscopic surgery is recommended as the primary surgical option for treating GERD due to its favorable perioperative profile and equivalent long-term efficacy.