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Functional evaluation at 1-year follow-up of laparoscopic Nissen-Rossetti fundoplication
Filippo Tosato1, Igor Monsellato, Salvatore Marano
1Department of General Surgery "F. Durante," Policlinico "Umberto I," University of Rome "Sapienza," Rome, Italy. filippo.tosato@uniroma.it
Insights
Laparoscopic Nissen fundoplication effectively treats gastroesophageal reflux disease, with 92% of patients asymptomatic after one year. This surgical approach offers significant symptom relief and high patient satisfaction.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Reflux Management
Background:
- Gastroesophageal reflux disease (GERD) significantly impacts patient quality of life.
- Laparoscopic Nissen fundoplication is the established surgical standard for refractory GERD.
- Long-term outcomes and patient satisfaction require continued evaluation.
Purpose of the Study:
- To evaluate the 1-year efficacy and safety of laparoscopic Nissen fundoplication.
- To assess postoperative acid reflux control using pH-metry.
- To determine patient satisfaction levels following the procedure.
Main Methods:
- Prospective study of 40 patients undergoing laparoscopic Nissen fundoplication.
- 30 patients completed 24-hour postoperative pH-metry.
- Clinical assessment and endoscopy with biopsies at 12-month follow-up.
Main Results:
- 92% of patients were asymptomatic at 12 months.
- Significant reduction in DeMeester and Johnson's score (44.7 to 7.75).
- Complete healing of esophagitis observed in all patients; 13% experienced transient dysphagia.
Conclusions:
- Laparoscopic Nissen fundoplication provides durable control of acid reflux.
- The procedure demonstrates a high degree of patient satisfaction with minimal complications.
- Surgical treatment significantly improves esophageal health and patient well-being.
Abstract:
Laparoscopic Nissen fundoplication is currently the gold standard for surgical treatment of gastroesophageal reflux disease. The aim of this study was to present our experience with this procedure at 1 year of follow-up. Forty patients were operated on between January 2006 and July 2007, and 30 underwent a 24-hour postoperative pH-metry study. Ninety-two percent of the patients were asymptomatic at a follow-up of 12 months. All pH-metric parameters improved. DeMeester and Johnson's score was reduced from 44.7 to 7.75; endoscopy with histologic samples revealed the healing of esophagitis in all patients; 4 (13%) patients complained of dysphagia, which resolved within 1 month after surgery. Twenty-seven (90%) patients were completely satisfied by their surgical results. One year after surgery, 24-hour ph-metric results show that laparoscopic Nissen fundoplication can completely control acid reflux with relatively few complications and a high degree of patient satisfaction.
