Symptomatic outcome of laparoscopic fundoplication, using a minimal dissection technique.
OBJECTIVE
The symptomatic outcome of 135 consecutive patients operated laparoscopically for gastro-oesophageal reflux disease (GORD) by a minimal paraoesophageal dissection technique is reported.


METHODS
At a median (range) follow-up time of 25 months (6-82 months) we sent the patients a self-assessment questionnaire regarding symptomatic outcome of the operation.


RESULTS
Median (range) operation time was 65 minutes (33-185 minutes). Per- and postoperative complications occurred in four patients (3%). There were no conversions and no mortality. The answering rate was 91%. Of all patients, 87% were free of reflux symptoms, 84% without any medication, 99% reported at least improvement, 90%-95% reported persistence of favourable outcome, 90% were satisfied, 91% scored the outcome as good or excellent, and 95% of the patients were ready to recommend the operation to family or friend. However, 31% reported dysphagia and 76% troublesome gas bloating, causing problems in 24% of the patients. No association between different outcome variables and crural repair could be shown.


CONCLUSIONS
Laparoscopic fundoplication can be done in a simple and fast way, with minimal morbidity, short hospital stay and without compromising outcome. Nevertheless, the operation is seldom without some sequel for the patient.
Victorzon
M
M
Gastrointestinal Unit, Surgical Department, Vasa Central Hospital, Vasa, Finland. mikael.victorzon@vshp.fi
Tolonen
P
P
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome