Laparoscopic Nissen fundoplication for gastroesophageal reflux disease in Japan.
OBJECTIVE
Laparoscopic antireflux surgery is the standard treatment for gastroesophageal reflux disease (GERD) in Western countries where this disorder is common; however, it has only recently been introduced in Japan. We examined the effectiveness of laparoscopic antireflux surgery in a small series of Japanese patients.


METHODS
Between 1998 and 2001 we performed laparoscopic Nissen fundoplication in 23 patients to evaluate the efficiency of this technique. We examined the following four parameters pre- and postoperatively: symptoms, endoscopic findings, gastroesophagogram findings, and the results of intraesophageal 24-h pH monitoring. We also examined the operation time, blood loss, intraoperative complications, and postoperative complications.


RESULTS
The operation was safely performed in all patients, regardless of age, and there were no intraoperative complications. Postoperatively, more than three parameters were effectively normalized in 17 (89.5%) of 19 patients. The only postoperative complications were delayed gastric emptying in three patients and persistent dysphagia in five patients. During follow-up, esophagitis recurred in two patients, one of whom underwent laparoscopic refundoplication, which normalized the condition.


CONCLUSIONS
Laparoscopic Nissen fundoplication is highly effective for GERD and could become the standard surgical treatment in Japan.
Takeyama
Satoshi
S
Department of Surgery, Asahikawa City Hospital, 1-1-65 Kinsei-cho, Asahikawa 070-8610, Japan.
Numata
Akihiko
A
Nenohi
Masaaki
M
Shibata
Yoshimi
Y
Okushiba
Shun-ichi
S
Katoh
Hiroyuki
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004941:Esophagitis / Q000209:etiology; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome