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Physiological and symptomatic outcome after laparoscopic gastric fundoplication
O J McAnena1, P D Willson, D F Evans
1Academic Surgical Unit, London Hospital Medical College, UK.
The British Journal of Surgery
|June 1, 1995
Summary
Laparoscopic fundoplication effectively treats gastro-oesophageal reflux, reducing symptoms and acid exposure. This minimally invasive approach offers reduced morbidity and faster recovery compared to open surgery.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Innovation
Background:
- Gastro-oesophageal reflux disease (GERD) poses significant challenges.
- Open antireflux operations carry potential complications.
- Laparoscopic techniques offer a promising alternative for reducing surgical morbidity.
Purpose of the Study:
- To evaluate the efficacy and safety of laparoscopic fundoplication for GERD.
- To assess the impact of the procedure on patient symptoms and objective reflux parameters.
- To compare the outcomes of laparoscopic fundoplication with traditional open surgery.
Main Methods:
- Prospective study of 15 patients with GERD undergoing laparoscopic fundoplication.
- Preoperative and postoperative assessments included clinical scoring, oesophageal pH monitoring, and manometry.
- Data analysis focused on operating time, hospital stay, complications, symptom scores, and physiological measurements.
Main Results:
- Median operating time was 115 minutes, with a median hospital stay of 3 days.
- No conversions to open surgery were required; only one minor wound infection occurred.
- Significant improvements were observed in DeMeester symptom scores (4 to 1.5, P=0.001) and lower oesophageal sphincter function.
- Nocturnal oesophageal acid exposure decreased significantly (9.6% to 0.05%, P=0.02).
Conclusions:
- Laparoscopic fundoplication is a safe and effective treatment for GERD.
- The procedure demonstrates reduced complications, improved symptoms, and objective evidence of decreased acid reflux.
- Early results suggest laparoscopic fundoplication combines the benefits of minimally invasive surgery with the efficacy of open antireflux operations.