title: Laparoscopic antireflux surgery for gastroesophageal reflux disease: experience with 668 laparoscopic antireflux procedures.
abstract: OBJECTIVE
  In the past decade laparoscopic antireflux surgery has become the standard operation for treating severe gastroesophageal reflux disease. Several studies have been published showing that it can achieve good to excellent results at short- and medium-term follow-up. We present our experience with 668 laparoscopic antireflux procedures.
  
  
  METHODS
  Between September 1993 and July 2001 we performed 668 laparoscopic antireflux procedures (76% laparoscopic 360 degrees "floppy" Nissen fundoplications in patients with normal esophageal motility, 24% laparoscopic 270 degrees Toupet partial fundoplications in patients with poor esophageal motility or severely disordered peristalsis). Patients with achalasia were excluded from analysis. Preoperative and postoperative data including 24-h pH monitoring, esophageal manometry, and analysis of failure were prospectively reviewed.
  
  
  RESULTS
  Overall complication rate was 7.6%. Conversion to open surgery was necessary in five patients (0.8%). Seventy-four laparoscopic redo procedures were performed due to failed primary intervention. There was no death. At a mean follow-up of 4.8 years (range 3-94 months) 24-h pH monitoring and esophageal manometry showed normal values in 93% of patients.
  
  
  CONCLUSIONS
  Laparoscopic antireflux surgery is feasible and effective and can be performed safely without mortality and low morbidity with good to excellent functional and symptomatic results.
authors.affiliation: Department of General Surgery, Hospital Zell am See, Paracelsusstrasse 8, 5700 Zell am See, Austria. fagzellamsee@yahoo.com
authors.forename: Frank Alexander
authors.initials: FA
authors.lastname: Granderath
authors.forename: Thomas
authors.initials: T
authors.lastname: Kamolz
authors.forename: Ursula Maria
authors.initials: UM
authors.lastname: Schweiger
authors.forename: Rudolph
authors.initials: R
authors.lastname: Pointner
mesh_terms: D001317:Austria; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000150:complications / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D010535:Laparoscopy; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D012008:Recurrence; D012086:Reoperation; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome