title: Five-year comprehensive outcomes evaluation in 181 patients after laparoscopic Nissen fundoplication.
abstract: BACKGROUND
  We conducted an objective followup of 181 patients after laparoscopic Nissen fundoplication during a 5-year period after surgery.
  
  
  METHODS
  Patients underwent 24-hour pH recording, esophageal manometry, and symptom score assessment for six gastroesophageal reflux disease symptoms preoperatively and at 6 months, 2 years, and 5 years after surgery.
  
  
  RESULTS
  Laparoscopic fundoplication was associated with a significant (p < 0.0001) increase in lower esophageal sphincter pressure and a significant (p < 0.0001) drop in duration of acid reflux in 24 hours, and symptom score, 6, 24, and 60 months after surgery when compared with preoperative values. Twenty-one patients (12%) have experienced recurrence of reflux-type symptoms, but only six have required repeat surgery. Lower esophageal sphincter tone dropped between 6 months and 5 years after surgery, but was still an effective antireflux barrier. Patient satisfaction with surgery dropped over the 5-year followup but remained high, at 86%, after 5 years.
  
  
  CONCLUSIONS
  Laparoscopic Nissen fundoplication remains an effective antireflux procedure at 5 years.
authors.affiliation: Centre for Minimal Access Surgery and Department of Medicine, St Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Mehran
authors.initials: M
authors.lastname: Anvari
authors.forename: Christopher
authors.initials: C
authors.lastname: Allen
mesh_terms: D000328:Adult; D003938:Diagnostic Techniques, Digestive System; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D013997:Time Factors; D016896:Treatment Outcome