Laparoscopic highly selective vagotomy with nissen fundoplication: is there any role?
BACKGROUND
Nissen fundoplication (NF) has not been a uniformly successful treatment for gastroesophageal reflux disease (GERD). Acid lowering procedures such as highly selective vagotomy (HSV) have not yet been fully evaluated as an adjunctive treatment. NFHSV was evaluated in GERD.


METHODS
Between June 2003 and June 2005, 8 women with a history of 6 months of GERD unrelieved by medication, preprandial pain, peptic ulcer disease, or severe gastritis underwent laparoscopic NFHSV. They have been followed for a mean 12 months. Preoperative and postoperative Heartburn Severity scores (HSS) were obtained.


RESULTS
Mean operative time was 110 minutes. There were no complications. One patient needed postoperative proton pump inhibitor, which was discontinued after smoking cessation 5 months after NFHSV. All 8 patients showed marked improvement in symptoms and HSS.


CONCLUSIONS
This series lends credence to the notion that NFHSV was effective. Several studies need to be performed to demonstrate the full efficacy and safety of this approach.
Division of General Surgery and Minimally Invasive Surgical Center, Texas Tech University Health Sciences Center, Lubbock, TX 79415, USA. eldo.frezza@ttuhsc.edu
Eldo E
EE
Frezza
Sharmila
S
Dissanaike
Mitchell S
MS
Wachtel
D000328:Adult; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014629:Vagotomy, Proximal Gastric / Q000379:methods*