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Resolving gastroesophageal reflux with laparoscopic fundoplication. Findings in 138 cases
P L Leggett1, R Churchman-Winn, C Ahn
1Department of Surgery, University of Texas-Houston Medical School, Houston 77030, USA.
Surgical Endoscopy
|February 28, 1998
Summary
Laparoscopic Nissen fundoplication effectively resolved gastroesophageal reflux in all patients. This minimally invasive procedure demonstrated comparable safety and efficiency, proving its successful transfer to community hospitals.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Gastroesophageal reflux disease (GERD) is a prevalent condition requiring effective treatment.
- Nissen fundoplication is a common surgical approach for managing GERD.
- Evaluating the transferability of laparoscopic Nissen fundoplication from academic to community settings is crucial for widespread adoption.
Purpose of the Study:
- To assess the efficacy and safety of laparoscopic Rossetti modification of Nissen fundoplication for GERD.
- To compare outcomes with existing literature on both open and laparoscopic fundoplication.
- To determine the feasibility of implementing this procedure in a community hospital environment.
Main Methods:
- 138 patients underwent laparoscopic Nissen fundoplication.
- Follow-up extended up to 45 months, monitoring reflux persistence and complications.
- Statistical analyses (Fisher's exact test, chi-square, t-test) compared findings with other studies.
Main Results:
- Complete resolution of GERD was achieved in all 138 patients.
- Complication rates (10.9%) and conversions to open surgery (1.5%) were not significantly different from other studies.
- Operative times and length of hospital stay demonstrated significant improvements and were comparable to established benchmarks.
Conclusions:
- Laparoscopic Nissen fundoplication is highly effective in resolving GERD.
- The procedure's outcomes, including complication rates and length of stay, align with existing literature.
- Successful implementation in a community hospital setting is feasible, highlighting its transferability from academic centers.