[Gastroesophageal reflux. Conventional surgery versus laparoscopic treatment. Prospective study (61 cases). Mano-Ph-metric evaluation at 4 months].
61 patients with aggressive gastro-esophageal reflux have been prospectively treated, 29 by open surgery and 32 by laparoscopy. There is no mortality and the morbidity is not significantly different (3 per cent vs 5 per cent). Hospital stay is strongly reduced in the laparoscopic group (5.4 days vs 8.9 days p = 0.02). Either the period of no professional activity (21.3 days vs 38.2 days p = 0.02). In both group, dysphagia is noted in 30% of the patients at 1 month and 3% at 4 months. All patients have had pre-operatively a mano-Ph-metry evaluation. At 4 months, the follow-up rate is 100% and all patient have been controlled with a 24 hours mano-Ph-metry. There is no difference between open and laparoscopic surgery. The mean SIO pressure had increased in both group from 3.6 mmHg to 18.1 mmHg (p = 0.001). There is only one failure in the beginning of the learning curve (4th patients in the "laparoscopy group" (3.1%). These study suggest that laparoscopic treatment could be proposed in the majority of failures of medical treatment in gastro-oesophageal reflux.
Service de Chirurgie Générale et Digestive, Hôpital Jean Verdier, Université Paris XIII, Bondy, France.
G
G
Champault
F
F
Volter
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N
Rizk
P
P
Boutelier
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D011859:Radiography
Reflux gastro-oesophagien. Chirurgie conventionnelle versus traitement laparoscopique. Etude prospective (61 cas). Evaluation mano-Ph-métrique à 4 mois.