Retrospective evaluation of patients of gastroesophageal reflux disease treated with laparoscopic Nissen's fundoplication.
OBJECTIVE
To evaluate retrospectively the outcome of laparoscopic fundoplication in a cohort of patients with typical symptoms of gastroesophageal reflux disease (GERD).


METHODS
Forty-two patients with typical symptoms of GERD, who were operated for laparoscopic Nissen's fundoplication from March 2001 to August 2008, were studied. The study was limited to patients with positive findings on upper gastrointestinal (GI) endoscopy done by us and "typical" symptoms (heartburn, regurgitation, and dysphagia) of GERD. Laparoscopic Nissen's fundoplication was performed when clinical assessment suggested adequate oesophageal motility and length. Only one patient who had negative endoscopic findings underwent a 24-h pH monitoring before surgery. Outcome measures included assessment of the relief of the primary symptom responsible for surgery in the early postoperative period; the patient's evaluation of outcome, and quality of life after surgery.


RESULTS
Relief of the primary symptom responsible for surgery was achieved in 95.24% of patients at a mean follow-up of 28 months. Thirty-five patients were asymptomatic, two had minor gastrointestinal symptoms not requiring medical therapy, three patients had gastrointestinal symptoms requiring medical therapy/Proton Pump Inhibitors (PPI) and in two patients the symptoms worsened after surgery. There were no deaths. Clinically significant complications occurred in six patients. Median hospital stay was 3 days, decreasing from 6 days in the first 10 patients to 3 days in the last 10 patients.


CONCLUSIONS
Laparoscopic Nissen's fundoplication is the choice of operation for clinically symptomatic GERD patients.
Nagpal
Anish P
AP
Department of Surgical Gastroenterolgogy and Advanced Laparoscopic Surgery, Haribhakti Surgical Hospital, Ahmedabad, Gujarat, India.
Soni
Harshad
H
Haribhakti
Sanjiv P
SP
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