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Journal of Gastrointestinal Surgery

, Volume 12, Issue 11, pp 1893–1899 | Cite as

Ten-year Outcome of Laparoscopic Antireflux Surgery

  • M. Fein
  • M. Bueter
  • A. Thalheimer
  • V. Pachmayr
  • J. Heimbucher
  • S. M. Freys
  • K.-H. Fuchs
2008 ssat poster presentation

Abstract

Background

Reflux recurrence is the most common long-term complication of fundoplication. Its frequency was independent from the type of fundoplication in randomized studies. Results for different techniques of laparoscopic antireflux surgery were retrospectively evaluated after 10 years.

Methods

From 1992 to 1997, 120 patients had primary laparoscopic fundoplication with a “tailored approach” (type of wrap chosen according to esophageal peristalsis): 88 received a Nissen, 22 an anterior, and 10 a Toupet fundoplication. Follow-up of 87% of the patients included disease-related questions and the gastrointestinal quality-of-life index (GIQLI).

Results

Of the patients, 89% would select surgery again. Heartburn was reported by 30% of the patients. Regurgitations were noted from 15% of patients after a Nissen, 44% after anterior fundoplication, and 10% after a Toupet (p = 0.04). Twenty-eight percent were on acid-suppressive drugs again. Following Nissen fundoplication, proton pump inhibitors were less frequently used (p = 0.01) and on postoperative pH-metry reflux recurrence rate was lower (p = 0.04). The GIQLI was 110 ± 24 without significant differences for the type of fundoplication.

Discussion

Ten years after laparoscopic fundoplication, overall outcome is good. A quarter of the patients are on acid-suppressive drugs. Nissen fundoplication appears to control reflux better than a partial fundoplication.

Keywords

Gastroesophageal reflux disease Antireflux surgery Long-term outcome Reflux recurrence 

Notes

Disclosure

The corresponding author declares that none of the authors has any connections whatsoever with the companies whose products are named in this paper or with any company in competition with those companies. The presentation of the topic is impartial and the contents are entirely product-neutral.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2008

Authors and Affiliations

  • M. Fein
    • 1
  • M. Bueter
    • 1
  • A. Thalheimer
    • 1
  • V. Pachmayr
    • 1
  • J. Heimbucher
    • 2
  • S. M. Freys
    • 3
  • K.-H. Fuchs
    • 4
  1. 1.Chirurgische Klinik und Poliklinik IKlinikum der Universität WürzburgWürzburgGermany
  2. 2.ChirurgieMarienkrankenhausKasselGermany
  3. 3.Chirurgische KlinikDIAKO Ev. Diakonie-KrankenhausBremenGermany
  4. 4.Allgemeinchirurgische KlinikMarkus-KrankenhausFrankfurtGermany

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