Thoracoscopic Belsey fundoplication with 5-year outcomes.
BACKGROUND
To determine the indications for a minimally invasive thoracic technique in gastroesophageal reflux disease (GERD), we conducted a retrospective review of outcomes with our first 21 thoracoscopic Belsey fundoplications.


METHODS
A thoracoscopic Belsey fundoplication was completed in 21 patients (12 males, 9 female; ages, 38-83 years). Preoperative evaluation revealed 13 primary motility disorders, 9 strictures, and 3 epiphrenic diverticuli. Six patients had previous gastric surgery. Sixteen patients underwent 20 ancillary procedures (esophagomyotomy, 14; excision of diverticulum, 2; lung volume reduction, 2; prosthetic diaphragmatic repair, 1; and Thal-Woodward esophagoplasty, 1).


RESULTS
Mean follow-up was 75.6 months (range, 67-85 months). There was one operative death (4.8%). Early morbidity included two esophageal leaks (9.8%). Late morbidity included three patients (15.7%) with persistent dysphagia and five patients (26%) with recurrent GERD.


CONCLUSIONS
Thoracoscopic Belsey fundoplication was associated with a high morbidity and recurrence rate in our long-term experience.
Champion
J K
JK
Department of Surgery, Emory-Dunwoody Medical Center, 4575 North Shallowford Road, Atlanta, GA 30038, USA. jkchamp@juno.com
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003964:Diaphragm / Q000601:surgery; D004240:Diverticulum / Q000150:complications / Q000601:surgery; D004940:Esophageal Stenosis / Q000150:complications / Q000601:surgery; D004943:Esophagogastric Junction / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D005764:Gastroesophageal Reflux / Q000209:etiology / Q000601:surgery*; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D011013:Pneumonectomy; D011183:Postoperative Complications / Q000453:epidemiology; D011312:Pressure; D012008:Recurrence; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome