Minimally invasive antireflux surgery.
BACKGROUND
Previous reports of minimally invasive antireflux surgery for gastroesophageal reflux disease (GERD) have been small, short-term series utilizing only a laparoscopic approach. We conducted a retrospective review and report our 66-month experience with more than 1,000 laparoscopic and thoracoscopic antireflux procedures.


METHODS
Between September 1991 and October 1997, 968 adults underwent 1,003 minimally invasive antireflux procedures on a tailored basis, based on their preoperative evaluation. Procedures performed were laparoscopic Nissen (626), Toupet (348), paraesophageal (33), and thoracoscopic Belsey (22). A total of 23% (233) of patients underwent an ancillary procedure (esophageal myotomy 85, vagotomy 67, pyloromyotomy 13, and cholecystectomy 66).


RESULTS
Follow-up averaged 33 months (range 1 to 66), operative mortality was 0.1%. Complications occurred in 2.7% with a 1% long-term dysphagia rate. Demonstrated recurrence rate was 3.8% to date, with an associated 3.4% reporting symptoms of GERD.


CONCLUSIONS
Minimally invasive antireflux procedures provide sustained relief of GERD symptoms with low morbidity and rapid recovery.
McKernan
J B
JB
Department of Surgery, Medical College of Georgia, Augusta, USA.
Champion
J K
JK
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome