Laparoscopic fundoplication: learning curve and patient satisfaction

Menon, Vijay; Manson, James; Baxter, J. N.

doi:10.1308/003588403321001345

Cited by 13 publications

(8 citation statements)

References 11 publications

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“…This case series supports recent literature that reports no complications performing LNF after a previous ELGP [7,11]. Although the long-term therapeutic effect of ELGP is still under investigation, the safety record of ELGP is outstanding.…”

Section: Discussionsupporting

confidence: 89%

Effects of prior endoluminal gastroplication on subsequent laparoscopic Nissen fundoplication

et al. 2007

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Section: Discussionsupporting

confidence: 89%

Effects of prior endoluminal gastroplication on subsequent laparoscopic Nissen fundoplication

et al. 2007

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“…Following laparoscopic antireflux surgery, dysphagia has been reported to significantly improve from preoperative values [47,188,197,198,[200][201][202][203][204] (level II-III). Despite reports of improved dysphagia following surgery, postoperative dysphagia remains a significant problem, with reported reoperation rates ranging from 1.8 to 10.8% [33,34,38,39,143,196,[205][206][207] (level I-III) and endoscopic dilatation rates ranging from 0 to 25% [34,121,143,145,189,195,196,[208][209][210][211][212][213] (level I-III). Although perioperative and early postoperative dysphagia have been reported as high as 76% [191] (level II), the majority of studies show early and mid dysphagia rates, up to 1 year postoperatively, of less than 20% [33,34,38,39,44,47,120,122,189,191,192,195,196,199,200,…”

Section: Discussionmentioning

confidence: 99%

“…Resumption of acid-reducing medications in patients after antireflux surgery has been reported to range widely (0-62%) at both short-term [ 189-191, 195, 196, 198-202, 204, 207, 209- 143,145,188,190,191,196,199,204,[206][207][208] 189, 191-193, 197, 209, 213, 214, 224] (level II-III). Recommendations 1.…”

Section: Postoperative Use Of Acid-reducing Medicationsmentioning

confidence: 99%

Guidelines for surgical treatment of gastroesophageal reflux disease

et al. 2010

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PreambleThe guidelines for the surgical treatment of gastroesophageal reflux disease (GERD) are a series of systematically developed statements to assist physicians and patient decisions about the appropriate use of laparoscopic surgery for GERD. The statements included in this guideline are the product of a systematic review of published literature on the topic, and the recommendations are explicitly linked to the supporting evidence. The strengths and weaknesses of the available evidence are highlighted and expert opinion sought where the evidence is lacking. This is an update of previous guidelines on this topic (last revision 06/2001) as new information has accumulated. DisclaimerGuidelines for clinical practice are intended to indicate preferable approaches to medical problems as established by experts in the field. These recommendations will be based on existing data or a consensus of expert opinion when little or no data are available. Guidelines are applicable to all physicians who address the clinical problem(s) without regard to specialty training or interests, and are intended to indicate the preferable, but not necessarily the only, acceptable approaches due to the complexity of the healthcare environment. Guidelines are intended to be flexible. Given the wide range of specifics in any health care problem, the surgeon must always choose the course best suited to the individual patient and the variables in existence at the moment of decision.Guidelines are developed under the auspices of the Society of American Gastrointestinal and Endoscopic Surgeons and its various committees, and approved by the Board of Governors. Each clinical practice guideline has been systematically researched, reviewed, and revised by the guidelines committee, and reviewed by an appropriate multidisciplinary team. The recommendations are therefore considered valid at the time of its production based on the data available. Each guideline is scheduled for periodic review to allow incorporation of pertinent new developments in medical research knowledge, and practice. Literature review methodWe identified 448 relevant articles. The abstracts were reviewed by four committee members (D.S., W.W.H., P.R.R., G.P.K.) and divided into the following categories:(a) Randomized studies, metaanalyses, and systematic reviews (b) Prospective studies (c) Retrospective studies (d) Case reports (e) Review articles Randomized controlled trials, metaanalyses, and systematic reviews were selected for further review, along with prospective and retrospective studies that included at least 50 patients. Studies with smaller samples were considered when additional evidence was lacking. The most recent reviews were also included. All case reports, older reviews, and smaller studies were excluded. According to these exclusion criteria, 227 articles were reviewed. Whenever the available evidence from level I studies was considered to be adequate, lower evidence level studies were not considered. A review of the available evidence on endoluminal treatment of...

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“…In addition, the relatively low mean procedural time compared to other endoscopic procedures or laparoscopic fundoplication could be a benefit of the GERDx™ device, considering aspects of cost-effectiveness [ 15 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical feasibility of a new full-thickness endoscopic plication device (GERDx™) for patients with GERD: results of a prospective trial

et al. 2018

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BackgroundPrevious studies suggest clinical effectiveness of endoscopic full-thickness plication in selected patients with gastroesophageal reflux disease (GERD). The aim of this study was to assess the clinical safety and efficiency of the GERDx™ device by evaluating clinical parameters, reflux symptom scores, and quality of life (QoL).MethodsProspective one-arm trial evaluating the outcome of forty patients with GERD subjected to endoscopic plication with the GERDx™ device. We included patients with at least one typical reflux symptom despite treatment with a PPI for > 6 months, pathologic esophageal acid exposure, hiatal hernia of size < 2 cm, and endoscopic Hill grade II–III. Evaluation of Gastrointestinal Quality of Life Index (GIQLI), symptom scores, esophageal manometry, and impedance-pH-monitoring were performed at baseline and at 3 months after surgery. (Trial Registration: ClinicalTrials.gov NCT 01798212.)ResultsThere were no intraoperative complications. Four out of forty patients experienced postoperative complications requiring intervention. Seven of forty patients were subjected to laparoscopic fundoplication 3 months after endoscopic plication due to persistent symptoms and were lost to further follow-up. Thirty out of forty patients were available at 3-month follow-up. There was an improvement of the GIQLI score, from a mean of 92.45 ± 18.47 to 112.03 ± 13.11 (p < 0.001). The general reflux-specific score increased from a mean of 49.84 ± 24.83 to 23.93 ± 15.63 (p < 0.001), and the DeMeester score from a mean of 46.48 ± 30.83 to 20.03 ± 23.62 (p < 0.001). There was no significant change in manometric data after intervention. Three of thirty patients continued daily antireflux medication.ConclusionsEndoscopic plication with the GERDx™ device reduced distal acid exposure of the esophagus, reflux-related symptoms, and improved GIQLI scores with minimal side effects in a selected cohort of patients and may be a safe alternative in the treatment of GERD.

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Laparoscopic fundoplication: learning curve and patient satisfaction

Abstract: The results show that LF is a safe procedure, takes longer than open procedure, and has an acceptable morbidity. Experience with the technique reduces the need for conversion. The mean length of hospital stay is significantly less and there is a high level of patient satisfaction.

Cited by 13 publications

References 11 publications

Effects of prior endoluminal gastroplication on subsequent laparoscopic Nissen fundoplication

Effects of prior endoluminal gastroplication on subsequent laparoscopic Nissen fundoplication

Guidelines for surgical treatment of gastroesophageal reflux disease

Clinical feasibility of a new full-thickness endoscopic plication device (GERDx™) for patients with GERD: results of a prospective trial

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