The Rossetti-Nissen fundoplication--effective in managing gastro-oesophageal reflux disease.
BACKGROUND
The report herein details a prospective audit of a unit's eight-year experience of the Rossetti-Nissen fundoplication using a predominantly laparoscopic technique, selective hiatal repair, no bougie and a standardised protocol of pre- and post-operative functional endoscopic and symptom assessment.


METHODS
Three hundred and seventy-eight patients underwent the Rossetti-Nissen fundoplication. All patients had documented data on endoscopy, health related quality of life (HR-QoL), surgical details and complications pre-operatively and at six months post-operatively. Repeat physiological testing was performed at six months.


RESULTS
At a median follow-up of six (range 3-13) months there was improved symptom scoring and HR-QoL after fundoplication with an 89% patient satisfaction rate. Ninety-five patients (25%) reported some early dysphagia, and 91 of these reported the outcome of surgery to be excellent or good. Thirty-eight patients (10%) had recurrent heartburn and 28 (7%) were back on medication at six months post-operatively. At follow-up pH study at a median of six months, 89% of patients had normalised acid reflux scores.


CONCLUSIONS
Rossetti-Nissen fundoplication, with no use of an oesophageal bougie and no division of short gastric vessels, is an effective procedure giving 89% patient satisfaction and significant improvement in QoL parameters and physiological measurements.
Byrne
P J
PJ
Trinity College Dublin, St James's Hospital, Ireland.
Ravi
N
N
Al-Sarraf
N
N
Rowley
S
S
Moran
T
T
Reynolds
J V
JV
D000293:Adolescent; D000328:Adult; D000368:Aged; D000863:Antacids / Q000627:therapeutic use; D003680:Deglutition Disorders / Q000503:physiopathology; D050782:Esophageal pH Monitoring; D004942:Esophagitis, Peptic / Q000503:physiopathology / Q000601:surgery; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000503:physiopathology / Q000601:surgery*; D006356:Heartburn / Q000503:physiopathology; D006551:Hernia, Hiatal / Q000601:surgery; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008365:Manometry; D008485:Medical Audit; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D012008:Recurrence; D016896:Treatment Outcome
D000863:Antacids