Symptom-focused results after laparoscopic fundoplication for refractory gastroesophageal reflux disease—a prospective study

Antoniou, Stavros A.; Delivorias, Panagiotis; Antoniou, George Α.; Natsiopoulos, Ioannis; Kalambakas, Athanasios; Dalenbäck, Jan; Makridis, C.

doi:10.1007/s00423-008-0294-6

Cited by 17 publications

(16 citation statements)

References 21 publications

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“…Pain and disfigurement are much less, and it allows better cosmesis, shortened recovery time and quicker return to preoperative well-being and normal activity [3]. Despite the minimally invasive nature of laparoscopy, host physiologic responses to stress are yet invariably activated.…”

Section: Discussionmentioning

confidence: 96%

“…The overall results on postoperative outcome have either been positive in favor of the glucocorticoid group or without differences between study groups, with postoperative nausea and vomiting and pain outcome parameters most significantly improved [5][6][7]. Data from LFNF have shown questionable effects on pain, nausea and vomiting [3], but show greater satisfaction and shorter stay in the day care unit [8].…”

Section: Introductionmentioning

confidence: 95%

“…The duration of convalescence, after noncomplicated LFNF, may depend on several factors of which pain, fatigue and sociocultural factors are the most important [3]. Pain and fatigue are most intense on the day of operation and the following day [2,3]. Nausea and vomiting occur mainly on the day of operation and only rarely contribute to prolonged convalescence [3].…”

Section: Introductionmentioning

confidence: 98%

“…Pain and fatigue are most intense on the day of operation and the following day [2,3]. Nausea and vomiting occur mainly on the day of operation and only rarely contribute to prolonged convalescence [3].…”

Section: Introductionmentioning

confidence: 99%

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How does dexamethasone influence surgical outcome after laparoscopic Nissen fundoplication? A randomized double-blind placebo-controlled trial

et al. 2010

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Laparoscopic floppy Nissen fundoplication (LFNF) is an effective treatment for gastroesophageal reflux disease. The duration of convalescence, after noncomplicated LFNF, may depend on several factors of which pain, fatigue and sociocultural factors are the most important. Nausea and vomiting occur mainly on the day of operation. Glucocorticoids are well known for their analgesic, anti-inflammatory, immune-modulating and antiemetic effects. We therefore undertook the present study to investigate whether preoperative dexamethasone could improve surgical outcome in patients undergoing uncomplicated laparoscopic floppy Nissen fundoplication. From March 2005 to April 2008, 82 patients were randomized to receive dexamethasone (8 mg) intravenously, 90 min before skin incision or saline (placebo). Patients received a similar standardized anesthetic, surgical and multimodal analgesic treatment. The primary end points were pain and fatigue. Preoperatively and at several times during the first 24 postoperative hours, we measured C-reactive protein (CRP), interleukin-6 and 1 (IL-6, IL-1), pain scores and nausea, and the number of vomiting episodes were registered. Dexamethasone significantly reduced postoperative levels of CRP (p = 0.01), IL-6 and IL-1 (p < 0.05), fatigue (p = 0.01) and overall pain during the first 24 postoperative hours (p < 0.05) and the total requirement of analgesic (ketorolac) (p < 0.05). Dexamethasone also reduced nausea and vomiting on the day of operation (p < 0.05). Preoperative dexamethasone (8 mg) reduced pain, fatigue, nausea and vomiting in patients undergoing uncomplicated LNF when compared with placebo.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

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How does dexamethasone influence surgical outcome after laparoscopic Nissen fundoplication? A randomized double-blind placebo-controlled trial

et al. 2010

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“…19–27 In 3 studies, symptoms improved as measured by GERD-HRQL score from 18.6–25 to 1.6–5. 20, 22, 23 At 10 years, Broeders et al reported resolution or improvement of symptoms in 92.4% of patients.…”

Section: Resultsmentioning

confidence: 99%

Review of antireflux procedures for proton pump inhibitor nonresponsive gastroesophageal reflux disease

Hillman

Yadlapati

Whitsett

et al. 2017

Diseases of the Esophagus

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Introduction Up to 40% of patients with gastroesophageal reflux disease (GERD) report persistent symptoms despite proton pump inhibitor (PPI) therapy. This review outlines the evidence for surgical and endoscopic therapies for the treatment of PPI non-responsive GERD. Material and Methods A literature search for GERD therapies from 2005–2015 in PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews identified unique 2928 citations. Of those, 45 unique articles specific to surgical and endoscopic therapies for PPI non-responsive GERD were reviewed. Results Laparoscopic fundoplication (n=19) provides symptomatic and physiologic relief out to 10 years, though efficacy wanes with time. Magnetic sphincter augmentation (n=6) and transoral incisionless fundoplication (n=9) improve symptoms in PPI non-responders, and may offer fewer side effects than fundoplication, though long-term follow-up is lacking. Radiofrequency energy delivery (n=8) has insufficient evidence for routine use in treating PPI non-responsive GERD. Electrical stimulator implantation (n=1) and endoscopic mucosal surgery (n=2) are emerging therapies for the treatment of GERD. Discussion Laparoscopic fundoplication remains the most proven therapeutic approach. Newer anti-reflux procedures such as magnetic sphincter augmentation and transoral incisionless fundoplication offer alternatives with varying degrees of success, durability, and side effect profiles that may better suit individual patients. Larger head-to-head comparison trials are needed to better characterize the difference in symptom response and side effect profiles.

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Regurgitation

DeVault¹

2017

Gastrointestinal Motility Disorders

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Symptom-focused results after laparoscopic fundoplication for refractory gastroesophageal reflux disease—a prospective study

Abstract: Laparoscopic fundoplication seems to be an effective treatment for severe, drug-resistant GERD. The high patient satisfaction rate and the positive therapeutic response in 95% of patients justify this procedure in this strictly selected group of patients.

Cited by 17 publications

References 21 publications

How does dexamethasone influence surgical outcome after laparoscopic Nissen fundoplication? A randomized double-blind placebo-controlled trial

How does dexamethasone influence surgical outcome after laparoscopic Nissen fundoplication? A randomized double-blind placebo-controlled trial

Review of antireflux procedures for proton pump inhibitor nonresponsive gastroesophageal reflux disease

Regurgitation

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