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Ten-year Outcome of Laparoscopic Antireflux Surgery

  • 2008 ssat poster presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

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.

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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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Authors and Affiliations

  1. Chirurgische Klinik und Poliklinik I, Klinikum der Universität Würzburg, Oberdürrbacherstr. 6, 97080, Würzburg, Germany

    M. Fein, M. Bueter, A. Thalheimer & V. Pachmayr

  2. Chirurgie, Marienkrankenhaus, Kassel, Germany

    J. Heimbucher

  3. Chirurgische Klinik, DIAKO Ev. Diakonie-Krankenhaus, Bremen, Germany

    S. M. Freys

  4. Allgemeinchirurgische Klinik, Markus-Krankenhaus, Frankfurt, Germany

    K.-H. Fuchs

Authors
  1. M. Fein
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  2. M. Bueter
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  3. A. Thalheimer
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  4. V. Pachmayr
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  5. J. Heimbucher
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  6. S. M. Freys
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  7. K.-H. Fuchs
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Correspondence to M. Fein.

Additional information

The results of the questionnaire have already been published in German in the journal ‘Der Chirurg’.

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Fein, M., Bueter, M., Thalheimer, A. et al. Ten-year Outcome of Laparoscopic Antireflux Surgery. J Gastrointest Surg 12, 1893–1899 (2008). https://doi.org/10.1007/s11605-008-0659-8

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  • DOI: https://doi.org/10.1007/s11605-008-0659-8

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