title: [Results of laparoscopic fundoplication in gastroesophageal reflux disease with atypical manifestations].
abstract: BACKGROUND
  Gastroesophageal reflux disease (GERD) may present with typical (heartburn and regurgitation) and atypical symptoms (cough, asthma, non-cardiac chest pain). Laparoscopic fundoplication has been performed for approximately 10 years, with results similar to or better than those obtained with open antireflux procedures. The aim of this study was to evaluate the clinical and functional results of laparoscopic fundoplication in patients with GERD and atypical symptoms.
  
  
  METHODS
  There were 158 consecutive patients with GERD who underwent a 360 degrees laparoscopic fundoplication (January 1999 to March 2006) and 27 patients had atypical symptoms. All patients underwent preoperative manometry and 24 hour pH-metry and 78% underwent the same tests postoperatively (at 6 months). Data from hospital records were analyzed and a clinical telephone survey was conducted.
  
  
  RESULTS
  There was no mortality and no conversions were required. The median length of follow-up was 21 months. All atypical symptoms (cough, chest pain, asthma, dysphonia and hoarseness) were significantly reduced (p < 0.05). There was no relationship between symptom persistence in five patients and pathologic acid reflux, except in one patient. Eighty-nine percent of the patients responded to the telephone survey; of these, 79% had no symptoms. The median satisfaction score was 9 (from 0 to 10).
  
  
  CONCLUSIONS
  Laparoscopic fundoplication for GERD with atypical symptoms is a safe procedure with good results (clinical and functional) in trained groups patients. Moreover a high satisfaction rate is obtained.
authors.affiliation: Unidad de Cirugía Esofagogástrica, Servicio de Cirugía General, Hospital Virgen del Camino, Pamplona, Navarra, España. adiazdea@cfnavarra.es
authors.forename: Alvaro Díaz
authors.initials: AD
authors.lastname: de Liaño
authors.forename: Sergio
authors.initials: S
authors.lastname: Zegarra
authors.forename: Eduardo
authors.initials: E
authors.lastname: Olivera
authors.forename: Concepción
authors.initials: C
authors.lastname: Yárnoz
authors.forename: Cristina
authors.initials: C
authors.lastname: Artieda
authors.forename: Ignacio
authors.initials: I
authors.lastname: Romeo
authors.forename: Héctor
authors.initials: H
authors.lastname: Ortiz
mesh_terms: D000328:Adult; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male