Clinical efficacy of the Toupet technique performed by laparoscopic surgery. Medium-term follow-up in 122 cases.
BACKGROUND
We present the results obtained in a series of patients with gastroesophageal reflux disease (GERD) who underwent the same type of laparoscopic surgery (Toupet technique).


METHODS
A total of 122 patients with symptomatic hiatal hernia and GERD were submitted to laparoscopic surgery between March 1993 and March 1999. In all patients, we performed a preoperative gastroduodenal radiological study, an upper gastrointestinal (GI) endoscopy, esophageal manometry, and 24-h pH monitoring. The same studies were repeated at 3 months. All patients were followed up clinically for ?1 year. The only laparoscopic technique used was the Toupet (270 degrees posterior fundoplication).


RESULTS
In 117 patients (95.9%), the clinical results were good, with complete disappearance of the symptoms. Two patients suffered a relapse, which was resolved by reintervention with laparoscopy. One patient experienced dysphagia and frequent chest pain for 5 months. Another two patients had moderate difficulty in belching. The endoscopic and radiological barium studies at 3 months were normal in all patients. Significant differences were seen in functional studies performed prior to and 3 months after the operation in all patients (p < 0.05).


CONCLUSIONS
Surgical laparoscopic treatment with the Toupet technique is effective both clinically and functionally. In cases of relapse, a new repair is possible with laparoscopy. Long-term follow-up of these patients is necessary to show whether these results are maintained over time.
Pozo
F
F
Servicio de Cirugía General y del Aparato Digestivo, Hospital Central de Asturias, C/ Celestino Villamil S. no., 33006 Oviedo, Spain.
Giganto
F
F
Rodrigo
L
L
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery*; D006551:Hernia, Hiatal / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged