Surgeons’ experience with laparoscopic fundoplication after the early personal experience: does it have an impact on the outcome?

Salminen, Paulina; Hiekkanen, Heikki; Laine, Seppo; Ovaska, Jari

doi:10.1007/s00464-006-9156-x

Cited by 19 publications

(12 citation statements)

References 34 publications

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“…The only previous study free of modifications of surgical technique violated the intention-to-treat principle because patients with major complications were excluded from follow-up and this percentage was twice as high in the learning group. 33 Despite these sources of bias, the results of the previous studies are in line with the present report and demonstrate that individual surgeon experience reduces operating time, 9,14,15,17 14,16,17 and surgical reinterventions 9,14 of LNF. In contrast, the current study and earlier reports show that objective reflux control 33 and long-term clinical outcome 17 are not correlated with experience.…”

Section: Commentsupporting

confidence: 92%

“…33 Despite these sources of bias, the results of the previous studies are in line with the present report and demonstrate that individual surgeon experience reduces operating time, 9,14,15,17 14,16,17 and surgical reinterventions 9,14 of LNF. In contrast, the current study and earlier reports show that objective reflux control 33 and long-term clinical outcome 17 are not correlated with experience. Once a good result is obtained, the effect lasts at least 5 years after surgery, as shown by postoperative reflux symptoms, proton pump inhibitor use, and quality of life.…”

Section: Commentsupporting

confidence: 92%

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Impact of Surgeon Experience on 5-Year Outcome of Laparoscopic Nissen Fundoplication

Broeders

Draaisma²,

Jong³

et al. 2011

Arch Surg

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To investigate the 5-year effect of surgeon experience with laparoscopic Nissen fundoplication (LNF). In 2000, a randomized controlled trial (RCT) was prematurely terminated because LNF for gastroesophageal reflux disease was associated with a higher risk to develop dysphagia than conventional Nissen fundoplication (CNF). Criticism focused on alleged bias caused by the relative lack of experience with the laparoscopic approach of the participating surgeons.Design: Multicenter RCT and prospective cohort study.Setting: University medical centers and tertiary teaching hospitals.Patients: In the RCT, 74 patients underwent CNF and 93 patients underwent LNF (LNFI). The complete setup of the cohort study (LNFII) (n = 121) mirrored the RCT, except that surgeon experience increased from more than 5 to more than 30 LNFs per surgeon.

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Section: Commentsupporting

confidence: 92%

Section: Commentsupporting

confidence: 92%

Impact of Surgeon Experience on 5-Year Outcome of Laparoscopic Nissen Fundoplication

Broeders

Draaisma²,

Jong³

et al. 2011

Arch Surg

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“…[ 19 ] Furthermore, it is known that with increasing experience from the surgeon, the complication and re-operation rate will decrease. [ 20 21 ] As mentioned before, it is known that patients with vagal nerve damage receive more frequent re-operations. [ 14 ] Since this was a retrospective study, we were unable to determine whether the patients who underwent a re-operation indeed had vagal nerve injury.…”

Section: Discussionmentioning

confidence: 99%

Quality of life after Nissen fundoplication in patients with gastroesophageal reflux disease: Comparison between long- and short-term follow-up

et al. 2018

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Introduction:Nissen fundoplication is the golden standard for surgical treatment of gastroesophageal reflux disease (GERD). Numerous studies report excellent short-term results. However, data regarding long-term quality of life are lacking. The aim of this study is to investigate the long-term quality of life after Nissen fundoplication in patients with GERD and to compare this with the short-term results.Patients and Methods:We retrospectively analysed all patients who underwent laparoscopic Nissen fundoplication for GERD between January 2004 and January 2016. All patients received a validated GERD-Health-Related Quality of Life questionnaire by mail to assess post-operative quality of life. Maximum quality of life is represented by a score of 75. Secondary outcome measures were complications and recurrence rate.Results:One hundred and seventy-five (77.1%) of the 227 operated patients returned the questionnaire. The median follow-up was 3.7 (0.1–10.3) years. Mean age was 51.6 (range 15–85) and 72 patients were male. We report an excellent quality of life with a median total score of 70 (range 2–75). Re-operation rate was 13.6% (23/169); the re-operation was due to recurrent reflux in 12 patients and due to persistent dysphagia in 11 patients. 91.3% of the re-operations were performed within the first 5 years after surgery. Mortality rate was zero.Conclusion:We report a large series of single-centre, single-surgeon laparoscopic Nissen fundoplication. Despite the re-operation rate of 13.6%, we found excellent long-term symptomatic outcome. There was no difference between short- and long-term results.

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“…Most studies report that the learning curve comprises 20 to 25 laparoscopic procedures under experienced tutelage [12,15,16]. However, no study has used patient symptoms outcome to assess the learning curve.…”

mentioning

confidence: 99%

Good training allows excellent results for laparoscopic Nissen fundoplication even early in the surgeon’s experience

et al. 2010

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Surgeons’ experience with laparoscopic fundoplication after the early personal experience: does it have an impact on the outcome?

Cited by 19 publications

References 34 publications

Impact of Surgeon Experience on 5-Year Outcome of Laparoscopic Nissen Fundoplication

Impact of Surgeon Experience on 5-Year Outcome of Laparoscopic Nissen Fundoplication

Quality of life after Nissen fundoplication in patients with gastroesophageal reflux disease: Comparison between long- and short-term follow-up

Good training allows excellent results for laparoscopic Nissen fundoplication even early in the surgeon’s experience

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