Symmetrical anterior-posterior partial fundoplication: technique and outcomes

Area of Science:

• Gastroenterology
• Surgical Innovation
• Patient Outcomes

Background:

• Partial fundoplication is a common surgical approach for managing gastroesophageal reflux disease (GERD).
• This study focuses on a specific symmetrical anterior-posterior partial (300°) fundoplication technique.
• The technique preserves the lesser curvature aspect of the esophagus.

Purpose of the Study:

• To evaluate the perioperative and long-term outcomes of a symmetrical anterior-posterior partial fundoplication.
• To assess the safety and efficacy of this specific GERD surgical treatment.
• To determine patient satisfaction and quality of life post-surgery.

Main Methods:

• Retrospective review of 355 patients undergoing primary elective antireflux surgery by a single surgeon (September 2016 - December 2024).
• Exclusion of non-primary, emergency procedures, and alternative techniques like Dor fundoplication.
• Assessment of perioperative complications, hiatal hernia recurrence, patient-reported outcome measures (PROMs), and patient satisfaction up to 7 years.

Main Results:

• The study included 355 patients (71.5% women, median age 64 years), with 79.2% undergoing laparoscopic surgery.
• Low rates of severe complications (0.8%) and no 90-day mortality were observed.
• Significant improvement in GERD-Health-Related Quality of Life (GERD-HRQL) scores, with median scores decreasing from 32 preoperatively to 1-5 postoperatively at various follow-up intervals up to 7 years.

Conclusions:

• Symmetrical anterior-posterior partial fundoplication is a safe and effective procedure for GERD.
• The technique provides sustainable symptom relief and high patient satisfaction up to 7 years post-surgery.
• Extended follow-up data is limited by a smaller patient cohort, warranting further investigation.