A comparison of laparoscopic Nissen fundoplication and Rossetti's modification in 239 patients

Leggett, P. L.; Bissell, C. D.; Churchman-Winn, R.; Ahn, Chul Soo

doi:10.1007/s004640020079

Cited by 31 publications

(22 citation statements)

References 16 publications

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“…Few studies have reported this technique for the pediatric population [13,14]. In adult series [15] Nissen-Rossetti modification is thought to be responsible for more dysphagia than the Nissen technique and division of the short gastric vessels, a reason why most adult surgeons advocate the classic Nissen instead of the Nissen-Rossetti procedure. However, a controlled study comparing the two approaches showed no difference between them in the occurrence of postoperative dysphagia [16].…”

Section: Discussionmentioning

confidence: 95%

Long-term outcome of laparoscopic Nissen-Rossetti fundoplication for neurologically impaired and normal children

et al. 2007

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Section: Discussionmentioning

confidence: 95%

Long-term outcome of laparoscopic Nissen-Rossetti fundoplication for neurologically impaired and normal children

et al. 2007

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“…Although no study has formally implicated division of short gastric vessels as a risk factor for delayed gastric empting, several randomized trials and meta‐analyses have found that routine division of short gastric vessels during laparoscopic fundoplication is associated with higher rates of postprandial bloating22, 23, 24, which may reflect delayed gastric emptying. Despite the rationale that division of short gastric vessels may facilitate the creation of a tension‐free fundoplication and minimize the risk of postoperative dysphagia25, multiple studies26, 27, 28, 29 have demonstrated that this intraoperative manoeuvre does not influence swallowing outcomes after antireflux surgery. Therefore, some surgeons no longer routinely divide the short gastric vessels30, 31, 32.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for delayed gastric emptying following laparoscopic repair of very large hiatus hernias

et al. 2017

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BackgroundDelayed gastric emptying can complicate surgery for hiatus hernia. The aim of this study was to quantify its incidence following laparoscopic repair of very large hiatus hernias, identify key risk factors for its occurrence and determine its impact on clinical outcomes.MethodsData collected from a randomized trial of patients who underwent laparoscopic mesh versus sutured repair of very large hiatus hernias (more than 50 per cent of stomach in chest) were analysed retrospectively. Delayed gastric emptying was defined as endoscopic evidence of solid food in the stomach after fasting for 6 h at 6 months after surgery.ResultsDelayed gastric emptying occurred in 19 of 102 patients (18·6 per cent). In univariable analysis, type 2 paraoesophageal hernia (relative risk (RR) 3·15, 95 per cent c.i. 1·41 to 7·06), concurrent anterior and posterior hiatal repair (RR 2·66, 1·14 to 6·18), hernia sac excision (RR 4·85, 1·65 to 14·24), 270°/360° fundoplication (RR 3·64, 1·72 to 7·68), division of short gastric vessels (RR 6·82, 2·12 to 21·90) and revisional surgery (RR 3·69, 1·73 to 7·87) correlated with delayed gastric emptying. In multivariable analysis, division of short gastric vessels (RR 6·27, 1·85 to 21·26) and revisional surgery (RR 6·19, 1·32 to 28·96) were independently associated with delayed gastric emptying. Delayed gastric emptying correlated with adverse gastrointestinal symptomatology, including higher rates of bloating, nausea, vomiting and anorexia, as well as reduced patient satisfaction with the operation and recovery.ConclusionDelayed gastric emptying following large hiatus hernia repair is common and associated with adverse symptoms and reduced patient satisfaction. Division of short gastric vessels and revisional surgery were independently associated with its occurrence.

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“…However, a high morbidity and mortality rate of open surgery performed in the elderly, limited the number of these patients referred to surgical units [25] . Since a laparoscopic Nissen fundoplication has been reported for the first time, a growing number of antireflux procedures have been performed in the USA [26] .…”

Section: Discussionmentioning

confidence: 99%

Influence of age on outcome of total laparoscopic fundoplication for gastroesophageal reflux disease

Pizza

Rossetti²,

Limongelli³

et al. 2007

WJG

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AIM: To demonstrate that age does not influence the choice of treatment for gastroesophageal reflux disease (GERD). We hypothesized that the outcome of total fundoplication in patients > 65 years is similar to that of patients aged ≤ 65 years. METHODS:Fo u r h u n d re d a n d t w e n ty c o n s e c ut i ve p a t i e n t s u n d e r w e n t t o t a l l a p a ro s c o p i c fu ndoplication for GERD. Three hundred and fifty-five patients were younger than 65 years (group Y), and 65 patients were 65 years or older (group E). T h e fo l l o w i n g e l e m e n t s w e re c o n s i d e re d : p re sence, duration, and severity of GERD symptoms; p re s e n c e o f a h i a t a l h e r n i a ; m a n o m e t r i c e va l uation, 24 h pH-monitoring data, duration of operation; incidence of complications; and length of hospital stay. RESULTS:Elderly patients more often had atypical symptoms of GERD and at manometric evaluation had a higher rate of impaired esophageal peristalsis in comparison with younger patients. A mild intensity of heartburn often leads physicians to underestimate the severity of erosive esophagitis. The duration of the operation was similar between the two groups. The incidence of intraoperative and postoperative complications was low and the difference was not statistically significant between the two groups. An excellent outcome was observed in 92.9% young patients and 91.9% elderly patients. CONCLUSION:Laparoscopic antireflux surgery is a safe and effective treatment for GERD even in elderly patients, warranting low morbidity and mortality rates and a significant improvement of symptoms comparable to younger patients.

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A comparison of laparoscopic Nissen fundoplication and Rossetti's modification in 239 patients

Cited by 31 publications

References 16 publications

Long-term outcome of laparoscopic Nissen-Rossetti fundoplication for neurologically impaired and normal children

Long-term outcome of laparoscopic Nissen-Rossetti fundoplication for neurologically impaired and normal children

Risk factors for delayed gastric emptying following laparoscopic repair of very large hiatus hernias

Influence of age on outcome of total laparoscopic fundoplication for gastroesophageal reflux disease

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