title: Laparoscopic Nissen fundoplication: predicting outcome from peri-operative evaluation.
abstract: BACKGROUND
  Although laparoscopic Nissen fundoplicaton is a safe, effective treatment for gastrooesophageal reflux (GOR), questions remain about the durability of the procedure and patient selection criteria.
  
  
  OBJECTIVE
  To review a single surgeon's experience of laparoscopic Nissen fundoplicaton and to determine which factors, if any are likely to influence long term outcome.
  
  
  METHODS
  Data were collected on all 124 patients who underwent laparoscopic Nissen fundoplication over a five-year period, and a detailed questionnaire was used to evaluate outcome.
  
  
  RESULTS
  Eighty-nine per cent of patients were satisfied with the results of surgery whilst 8.8% of patients had significant recurrence of symptoms. Time since surgery was longer in those patients with symptom recurrence who were also more likely to be female. Pre-operative age, body mass index (BMI),Visick Score, endoscopic findings or pH analysis scores were not predictive of outcome, nor were intra-operative findings or post-operative complications.
  
  
  CONCLUSIONS
  Although laparoscopic Nissen fundoplication is a safe and effective treatment for GOR, it is difficult to predict the small but significant group of patients with poor longterm outcome based on pre-operative assessment and peri-operative parameters alone.
authors.affiliation: Dept of Surgery, Our Lady of Lourdes Hospital, Drogheda, Co Louth.
authors.forename: B J
authors.initials: BJ
authors.lastname: Manning
authors.forename: R
authors.initials: R
authors.lastname: Salman
authors.forename: P
authors.initials: P
authors.lastname: Gillen
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome