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Prospective study of routine day-case laparoscopic modified Lind partial fundoplication.
S Agrawal1, I Shapey, A Peacock
1Department of General and Upper GI Surgery, Birmingham Heartlands Hospital, Bordesley Green East, Birmingham, B9 5SS, UK. sanju_agrawal@hotmail.com
World Journal of Surgery
|April 14, 2009
Summary
Day-case laparoscopic modified Lind fundoplication for gastroesophageal reflux disease is safe and feasible. This approach leads to high patient satisfaction and reduced hospital costs, making it a viable option for select patients.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Health Economics
Background:
- Gastroesophageal reflux disease (GERD) management often involves surgical intervention.
- Laparoscopic fundoplication is a common surgical treatment for GERD.
- Assessing day-case surgery feasibility is crucial for healthcare efficiency.
Purpose of the Study:
- To evaluate the feasibility, safety, and acceptability of routine day-case laparoscopic modified Lind fundoplication for GERD.
- To determine the impact on hospital healthcare costs.
Main Methods:
- Prospective study of 130 laparoscopic modified Lind fundoplications (Nov 2005-Nov 2007).
- Inclusion criteria: American Society of Anesthesiologists (ASA) grade I-II, adequate home support.
- Follow-up at 6 weeks (clinic) and 1 year (postal questionnaire).
Main Results:
- 103 patients (79.2%) met day-case criteria; 90 (87.4%) were discharged same-day.
- No same-day discharge-related complications; <3% readmission rate.
- High patient satisfaction and reflux-free status at 6 weeks; significant symptom reduction at 1 year.
Conclusions:
- Routine day-case laparoscopic modified Lind fundoplication is safe, well-tolerated, and cost-effective for select GERD patients.
- Patients with ASA grade >2 and those requiring redo surgery are not candidates for day-case procedures.
- High patient satisfaction and symptom relief support this approach for appropriate candidates.
