Despite an overall decrease in use, abdominoperineal resection will continue to play an important role for the surgical treatment of low rectal cancers in routine clinical practice in Germany. It will remain an individual decision for each patient whether the tumor and the patient allow sphincter preservation or whether abdominoperineal resection seems to be necessary. According to the results of the present study,a general definition of an abdominoperineal resection rate in an unselected group of patients should be viewed critically.

In a period of 4 years between March 1994 and March 1998, 143 patients with gastroesophageal reflux disease (GERD) underwent laparoscopic antireflux surgery. According to manometric studies 76 patients had a short-floppy Nissen fundoplication, patients with impaired motility or paraesophageal hernias received a hemifundoplication (Toupet = 42, Dor/Thal = 25). Recurrent reflux symptoms appeared in 6.3% after mean 16.7 months follow-up (Nissen = 2.6%, Toupet = 2.3%, Dor/Thal = 24%, P < 0.01). Persistent dysphagia with reoperation occurred in 2.1% (Nissen = 2.6%, Toupet = 2.3%, Dor/Thal = 0%, n.s.). The assessment of Visick's score at the latest control showed the following: Visick I = 63.6%, Visick II = 30.1%, Visick III = 6.3%, Visick IV = 0%. The outcome of the operation was rated "excellent" or "good" by 91.6% of the patients.