The team evaluated the long-term outcome of laparoscopic Nissen fundoplication for gastroesophageal reflux disease and reported their findings in the February issue of Archives of Surgery.
178 patients who underwent laparoscopic Nissen fundoplication between September 1991 and June 1994 were included in the study, and their outcome was compared with data from open procedures.
An independent investigator, who interviewed patients using a structured questionnaire, obtained long-term follow-up for 5 or more years after surgery.
99% of the 178 patients successfully completed the follow-up.
9 patients died at some stage following surgery.
Hence, questionnaire data were available for 166 patients, at a median follow-up of 6 years.
|90% of patients considered the long-term outcome of laparoscopic Nissen fundoplication to be good or excellent.
| Archives of Surgery |
3 patients (1.7%) underwent revision surgery for recurrent reflux; 87% of the 176 patients remained free of significant reflux.
The researchers found that re-operation was required for dysphagia in 7 patients (3.9%) - 2 for a tight wrap and 5 for a tight diaphragmatic hiatus. In addition, re-operation was necessary for a para-esophageal hiatus hernia in 13 patients (7.3%).
Of the re-operations, 56% were performed within 12 months of the original procedure, and 22% during the second year of follow-up. Further surgery was found to be uncommon after 2 years.
90% of patients considered the long-term outcome to be "good or excellent".
Dr Thiery Lafullarde concluded from the study, "The long-term outcome of laparoscopic Nissen fundoplication is similar to that following open fundoplication. Good results are obtained in most patients."