[Gastroesophageal reflux. Conventional surgery versus laparoscopic treatment. Prospective study (61 cases)....

61 patients with aggressive gastro-esophageal reflux have been prospectively treated, 29 by open surgery and 32 by laparoscopy. There is no mortality and the morbidity is not significantly different (3 per cent vs 5 per cent). Hospital stay is strongly reduced in the laparoscopic group (5.4 days vs 8.9 days p = 0.02). Either the period of no professional activity (21.3 days vs 38.2 days p = 0.02). In both group, dysphagia is noted in 30% of the patients at 1 month and 3% at 4 months. All patients have had pre-operatively a mano-Ph-metry evaluation. At 4 months, the follow-up rate is 100% and all patient have been controlled with a 24 hours mano-Ph-metry. There is no difference between open and laparoscopic surgery. The mean SIO pressure had increased in both group from 3.6 mmHg to 18.1 mmHg (p = 0.001). There is only one failure in the beginning of the learning curve (4th patients in the "laparoscopy group" (3.1%). These study suggest that laparoscopic treatment could be proposed in the majority of failures of medical treatment in gastro-oesophageal reflux.