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Endoscopic Evaluation of Laparoscopic Nissen Fundoplication: 89 % Success Rate 10 Years After Surgery

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Abstract

Background

The surgical outcome of fundoplication can be evaluated by means of esophagogastroduodenoscopy (EGDS). The literature reveals only one prior long-term follow-up series with endoscopic evaluation of the fundoplication wraps after laparoscopic Nissen fundoplication (LNF). The results achieved at a university clinic showed LNF to be more durable than open fundoplication (ONF). Previously, in our community-based hospital, the results of ONF were somewhat poorer than those achieved at a university clinic. The objective of the present study was to describe the long-term results of LNF in our hospital as regards surgical and symptomatic outcomes.

Methods

In 1997–1999, 107 LNFs were performed in our hospital. A questionnaire with symptom evaluation was mailed to all patients. The patients who agreed to participate were interviewed and underwent EGDS.

Results

Of the 107 patients, 64 (59.8 %) participated in the study (40 men, mean age 61.9 years, range 28–85 years). The mean follow-up time was 9.8 years. Seven endoscopic examinations (10.9 %) showed a defective fundic wrap; three of the patients had undergone reoperation. Fifty-eight (90.6 %) patients had no or minimal heartburn and 61 (95.3 %) had no or minimal regurgitation. Twenty-three (35.9 %) patients had moderate or severe dysphagia, and 43 (67.2 %) patients had moderate or severe flatulence. Fifty-seven (89.1 %) patients would have opted for surgery again.

Conclusions

This study contributes to the previous notion that LNF is associated with fewer surgical failures than ONF. Our results indicate that LNF can well be performed in a community-based hospital with acceptable long-term results.

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Acknowledgments

The patients were interviewed by Sari Salomaa. The data analyses were done in collaboration with Jukka Ollgren and Rami Uurainen. This study was supported by the Häme Regional Fund of the Finnish Cultural Foundation and by the Competitive Research Funding of the Seinäjoki Central Hospital.

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Authors and Affiliations

  1. Department of Surgery, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220, Seinäjoki, Finland

    Perttu Neuvonen & Tuomo Rantanen

  2. Department of Surgery, Kanta-Häme Central Hospital, Ahvenistontie 20, 13530, Hämeenlinna, Finland

    Mauri Iivonen

  3. Department of Surgery, Forssa Hospital, Urheilukentänkatu 9, 30100, Forssa, Finland

    Mauri Iivonen

  4. Department of Surgery, Linnan Klinikka Hospital, Raatihuoneenkatu 10, 13100, Hämeenlinna, Finland

    Mauri Iivonen

  5. Department of Surgery, Kuopio University Hospital, Box 100, 70029, Kuopio, Finland

    Tuomo Rantanen

Authors
  1. Perttu Neuvonen
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  2. Mauri Iivonen
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  3. Tuomo Rantanen
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Correspondence to Tuomo Rantanen.

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Neuvonen, P., Iivonen, M. & Rantanen, T. Endoscopic Evaluation of Laparoscopic Nissen Fundoplication: 89 % Success Rate 10 Years After Surgery. World J Surg 38, 882–889 (2014). https://doi.org/10.1007/s00268-013-2349-2

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  • DOI: https://doi.org/10.1007/s00268-013-2349-2

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