title: The durability of laparoscopic Nissen fundoplication: 11-year outcomes.
abstract: Laparoscopic Nissen fundoplication (LNF) has become the most commonly performed antireflux procedure since its introduction in 1991. There are few studies with greater than 5-year outcomes. Herein we report a series of 312 consecutive patients who underwent primary LNF before 1996. Follow-up of more than 6 years was available in 166 patients, and the mean follow-up was 11 years (median 11.1 years, range 6.1-13.3 years). Prospective data collection included preoperative and current symptom scores (scale 0 = none to 3 = severe), as well as the level of patient satisfaction and use of antireflux medications. Total symptom score for each patient was summed from seven symptoms for a maximum value of 21. Heartburn and regurgitation were the most improved symptoms; however, all symptoms were significantly improved (P < 0.01). The total symptom score at follow-up was 2.6 down from 7.5 at baseline, with a mean difference of -4.9 (range -12 to 3). The percentage of patients stating they would have the procedure again was 93.3%, and 70% were off daily antireflux medications. Outcomes at a mean of 11 years after LNF are excellent, and the majority of patients had their symptoms resolved or significantly improved and are satisfied with their results.
authors.affiliation: Department of Surgery, Emory Endosurgery Unit, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Craig B
authors.initials: CB
authors.lastname: Morgenthal
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Shane
authors.forename: Alessandro
authors.initials: A
authors.lastname: Stival
authors.forename: Nana
authors.initials: N
authors.lastname: Gletsu
authors.forename: Graham
authors.initials: G
authors.lastname: Milam
authors.forename: Vickie
authors.initials: V
authors.lastname: Swafford
authors.forename: John G
authors.initials: JG
authors.lastname: Hunter
authors.forename: C Daniel
authors.initials: CD
authors.lastname: Smith
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012008:Recurrence; D016896:Treatment Outcome