Antirefluxchirurgie in Deutschland Ergebnisse einer repräsentativen Umfrage mit Analyse von 2.540 Antirefluxoperationen

Hüttl, T. P.; Höhle, Michael; Meyer, G.; Schildberg, F. W.

doi:10.1007/s00104-001-0421-1

Cited by 21 publications

(27 citation statements)

References 21 publications

(34 reference statements)

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“…The Nissen technique is afflicted with a possibly important incidence of postoperative dysphagia depending on the creation of the wrap [18,19,20]. While a meta-analysis found dysphagia in 23% after performing a 360° wrap [1], recent investigations showed a considerable reduction of these complains [21].…”

Section: Discussionmentioning

confidence: 99%

Nissen versus Dor Fundoplication for Treatment of Gastroesophageal Reflux Disease: A Blinded Randomized Clinical Trial

Raue

Ordemann

Jacobi³

et al. 2011

Dig Surg

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Introduction: Fundoplication techniques for treatment of gastroesophageal reflux are discussed concerning impairments and success. This randomized trial was conducted to compare Nissen’s wrap and the anterior partial technique (Dor) concerning patients’ quality of life (QoL) and functional data after a mid-term follow-up. Methods: In a 24-month period, 64 patients were equally randomized into group A (Nissen’s fundoplication) and group B (180° anterior partial fundoplication). After a mean follow-up of 18 months, all patients were examined and interviewed using standardized QoL questionnaires (Gastrointestinal Quality of Life Index), Visick score, 24-hour pH-metry and esophageal manometry. Data of 57 patients (group A: 27, group B: 30) could be analyzed. Results: After partial fundoplication, 9 patients (30%) stated the operative results were worse than perfect. Only 2 patients (7%) evaluated the outcome after Nissen’s fundoplication as unsuccessful (p = 0.04). However, postoperative Gastrointestinal Quality of Life Index showed no differences between groups (p = 0.5). Additionally, functional data were not different (DeMeester 10 vs. 12, p = 0.17, and lower esophageal sphincter pressure 13 vs. 12 mm Hg, p = 0.5). Conclusion: The anterior partial fundoplication technique did not lead to disadvantages in postoperative QoL, physiological function and reflux control when compared to Nissen’s approach in a mid-term follow-up.

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Section: Discussionmentioning

confidence: 99%

Nissen versus Dor Fundoplication for Treatment of Gastroesophageal Reflux Disease: A Blinded Randomized Clinical Trial

Raue

Ordemann

Jacobi³

et al. 2011

Dig Surg

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“…However, the various fundoplication procedures are controversial and have been debated in regard to their role in controlling reflux symptoms. The partial fundoplication techniques were introduced in order to reduce the high rate of postoperative dysphagia caused by total 360° fundoplication (Nissen) of up to 50% [6,13,14]. This superiority has been presented in prospective randomized trials for posterior 270° and anterior fundoplication [14,15,16,17].…”

Section: Discussionmentioning

confidence: 99%

“…The optimal method for laparoscopic fundoplication still remains a controversial issue. It seems that the most widely used procedures in Germany are the Nissen 360° fundoplication and partial posterior 270° fundoplication (Toupet) [6]. Other methods such as anterior partial 180° fundoplication (Dor, which is favorably performed in our department), partial 120° fundoplication (Watson) and the Thal technique have received different comments and evaluation in the literature or have been criticized, mainly because of a suspected increase in the frequency of reflux symptom recurrence.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Postoperative Long-Term Quality of Life after Laparoscopic Anterior Partial Fundoplication in the Treatment of Gastroesophageal Reflux Disease

Raue

Menenakos²,

Braumann³

et al. 2009

Dig Surg

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Background: In the treatment of gastroesophageal reflux disease (GERD), anterior fundoplications are emphasized for their lower risk of complications compared to the posterior approach. Aim: The aim of this study was to evaluate the long-term results of laparoscopic anterior 180° fundoplication in consideration of quality of life and reflux control. Methods: One hundred and twenty-four patients suffering from GERD underwent laparoscopic anterior 180° fundoplication and were enrolled in this observational trial. After a mean follow-up of 52 months, 95 patients remained in the study. The success of reflux control and the quality of life were assessed using standardized questionnaires (Gastrointestinal Quality of Life Index and Reflux Activity Index scores). Results: Seventy-one patients (75%) reported that the operation was fully successful. Three patients (2%) had no clear opinion, while 21 patients (22%) reported they were poorly or not satisfied. Statistical evaluation of the questionnaires showed a clear difference (p < 0.001) in quality of life scores of patients who needed a continuous postoperative treatment for GERD compared to completely satisfied patients. Conclusion: The laparoscopic anterior 180° partial fundoplication for the treatment of GERD can result in satisfying reflux control in long-term outcome, but the postoperative quality of life is severely affected by the success of the treatment.

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“…According to these authors, gas embolism appears to be a rare complication which is usually associated with the placement of a Veress needle directly into a vein [22]. As opposed to Larach and Gallagher [22] who recommend not to use the Veress needle for installation of the pneumoperitoneum, Hüttl et al [23] showed that most surgeons in Germany (70%) still apply this method for placement of the initial port. In addition to the above-mentioned perioperative complications, pneumothorax, cardiac arrhythmia, impaired venous return, venous thrombosis as well as peripheral nerve injury have been associated with the increased intraabdominal pressure as well as patient's positioning during surgery [22].…”

Section: Surgical Safetymentioning

confidence: 99%

Recent Advances in Minimally Invasive Colorectal Cancer Surgery

et al. 2002

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SummaryLaparoscopy has improved surgical treatment of various diseases due to its limited surgical trauma and has developed as an interesting therapeutic alternative for the resection of colorectal cancer. Despite numerous clinical advantages (faster recovery, less pain, fewer wound and systemic complications, faster return to work) the laparoscopic approach to colorectal cancer therapy has also resulted in unusual complications, i.e. ureteral and bladder injury which are rarely observed with open laparotomy. Moreover, pneumothorax, cardiac arrhythmia, impaired venous return, venous thrombosis as well as peripheral nerve injury have been associated with the increased intraabdominal pressure as well as patient's positioning during surgery. Furthermore, undetected small bowel injury caused by the grasping or cauterizing instruments may occur with laparoscopic surgery. In contrast to procedures performed for nonmalignant conditions, the benefits of laparoscopic resection of colorectal cancer must be weighed against the potential for poorer long-term outcomes of cancer patients that still has not been completely ruled out. In laparoscopic colorectal cancer surgery, several important cancer control issues still are being evaluated, i.e. the extent of lymph node dissection, tumor implantation at port sites, adequacy of intraperitoneal staging as well as the distance between tumor site and resection margins. For the time being it can be assumed that there is no significant difference in lymph node harvest between laparoscopic and open colorectal cancer surgery if oncological principles of resection are followed. As far as the issue of port site recurrence is concerned, it appears to be less prevalent than first thought (range 0-2.5%), and the incidence apparently corresponds with wound recurrence rates observed after open procedures. Short-term (3-5 years) survival rates have been published by a number of investigators, and survival rates after laparoscopic surgery appears to compare well with data collected after conventional surgery for colorectal cancer. However, long-term results of prospective randomized trials are not available. The data published so far indicate that the oncological results of laparoscopic surgery compare well with the results of the conventional open approach. Nonetheless, the limited information available from prospective studies leads us to propose that minimally invasive surgery for colorectal cancer surgery should only be performed within prospective trials. Vorteile der laparoskopischen Chirurgie bei malignen Erkrankungen gegen die potentiell schlechteren onkologischen Langzeitergebnisse abgewogen werden, welche bislang noch nicht endgültig ausgeschlossen werden konnten. Diesbezüglich gibt es wesentliche onkologische Kriterien, die sich bei der laparoskopischen Chirurgie noch in der Evaluation befinden. Hierzu zählen unter anderem das Ausmaß der Lymphknotendissektion, die Frage der Tumorzellimplantation im Bereich der Trokarinzisionen, die Qualität des intraoperativen Tumor-Stagings sowie ...

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Antirefluxchirurgie in Deutschland Ergebnisse einer repräsentativen Umfrage mit Analyse von 2.540 Antirefluxoperationen

Abstract: Laparoscopy has replaced the open technique. Different technical approaches significantly affect the outcome after laparoscopic antireflux surgery in Germany.

Cited by 21 publications

References 21 publications

Nissen versus Dor Fundoplication for Treatment of Gastroesophageal Reflux Disease: A Blinded Randomized Clinical Trial

Nissen versus Dor Fundoplication for Treatment of Gastroesophageal Reflux Disease: A Blinded Randomized Clinical Trial

Evaluation of Postoperative Long-Term Quality of Life after Laparoscopic Anterior Partial Fundoplication in the Treatment of Gastroesophageal Reflux Disease

Recent Advances in Minimally Invasive Colorectal Cancer Surgery

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