Retrospective evaluation of patients of gastroesophageal reflux disease treated with laparoscopic Nissen′s fundoplication

Abstract

AIMS:To evaluate retrospectively the outcome of laparoscopic fundoplication in a cohort of patients with typical symptoms of gastroesophageal reflux disease (GERD).MATERIALS AND METHODS:Forty-two patients with typical symptoms of GERD, who were operated for laparoscopic Nissen's fundoplication from March 2001 to August 2008, were studied. The study was limited to patients with positive findings on upper gastrointestinal (GI) endoscopy done by us and "typical" symptoms (heartburn, regurgitation, and dysphagia) of GERD. Laparoscopic Nissen's fundoplication was performed when clinical assessment suggested adequate oesophageal motility and length. Only one patient who had negative endoscopic findings underwent a 24-h pH monitoring before surgery. Outcome measures included assessment of the relief of the primary symptom responsible for surgery in the early postoperative period; the patient's evaluation of outcome, and quality of life after surgery.RESULTS:Relief of the primary symptom responsible for surgery was achieved in 95.24% of patients at a mean follow-up of 28 months. Thirty-five patients were asymptomatic, two had minor gastrointestinal symptoms not requiring medical therapy, three patients had gastrointestinal symptoms requiring medical therapy/Proton Pump Inhibitors (PPI) and in two patients the symptoms worsened after surgery. There were no deaths. Clinically significant complications occurred in six patients. Median hospital stay was 3 days, decreasing from 6 days in the first 10 patients to 3 days in the last 10 patients.CONCLUSIONS:Laparoscopic Nissen's fundoplication is the choice of operation for clinically symptomatic GERD patients.

Reflux and sex

“…The majority of reports originated in Europe (n = 83) and North America (n = 55) [121,. The remaining series originated in Australia or New Zealand (n = 11) [290][291][292][293][294][295][296][297][298][299][300], Asia (n = 8) [301][302][303][304][305][306][307][308], Africa or the Arab peninsula (n = 3) [309][310][311] or South America (n = 2) [312,313]. Overall, the case series reported a male predominance with women accounting for 46.2 ± 0.9% (range: 30.3-91.0%; P < 0.01) of the patients.…”

Management of Gastroesophageal Reflux Disease: A Review of Medical and Surgical Management

“…They had also found that gastroesophageal reflux disease had equal sex distribution (50% for males and females) [ 3 ]. Nagpal et al [ 4 ] found that 57.14% of the patients were males and 42.86% were females [ 4 ].…”

“…Angina like chest pain and respiratory symptoms (cough and hoarseness) were not seen ( Table 1 ). In the study done by Nagpal et al [ 4 ], the most common symptom was heartburn, followed by regurgitation and constipation [ 4 ]. In a study of 107 patients done by Balsara et al [ 6 ], the symptoms on presentation were heartburn in all (100%), regurgitation in 43 (50.59%), and volume reflux in 39 (45.88%) patients [ 6 ].…”

Gastro-œsophageal reflux disease and surgery

“…La définition de l'échec n'est pas clairement établie et reste peu consensuelle. La récidive du pyrosis et des régurgitations peuvent survenir dans 10 % à 18 % des cas dans les 5 à10 ans post-opératoires 80,81 . Une récente étude suédoise ayant colligé 2.655 patients ayant eu une chirurgie laparoscopique anti-reflux avec un suivi de 5,1 années montrait un taux de récidive de 17,7 %.…”