Gastroesophageal reflux: conventional surgical treatment versus laparoscopy. A prospective study of 61 cases.
Sixty-one patients with gastroesophageal reflux who did not respond to conventional medical treatment were treated in a prospective study, 29 by conventional surgery and 32 by laparoscopic methods. All underwent manometry and pH measurement preoperatively and at a follow-up of four months. There was no mortality, and the morbidity of the two groups was not significantly different at 3% and 5%. Hospital stay was significantly reduced (5.4 versus 8.9 days; p = 0.02) following laparoscopic treatment, and time off from work was 21.3 days versus 38.2 days (p = 0.02). The satisfaction index expressed by the patients was 65% at 1 month and 95% at 3 months. Dysphagia was observed in 30% of the patients at 1 month and in 3% at 4 months in both groups. The results of manometry and pH measurements at 4 months are comparable between open surgery and laparoscopy. There was one failure (3%) in the laparoscopic group caused by disruption of the valve. The mean pressure in the esophageal segment (expressed in mm Hg) changed in the two groups from 3.6 to 18.1 (p = 0.001). The results of this series show laparoscopic management of gastroesophageal reflux to be justified.
Champault
G
G
General and GI Surgery Unit, Hospital Jean Verdier, Bondy, France.
Volter
F
F
Rizk
N
N
Boutelier
P
P
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005069:Evaluation Studies as Topic; D005260:Female; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology*; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000379:methods*; D016896:Treatment Outcome