title: Long-term results of laparoscopic Nissen fundoplication with or without short gastric vessels division.
abstract: BACKGROUND
  It has been claimed that division of the short gastric vessels (SGV) during laparoscopic Nissen fundoplication (LNF) could reduce the risk of postoperative dysphagia. The aim of this study was to compare patients who underwent LNF with (SGV+) or without (SGV-) SGV division in our institution and present long-term results.
  
  
  METHODS
  Retrospective case note review study of patients undergoing LNF with or without division of the SGV. Outcomes included DeMeester score, low esophageal sphincter resting pressure, and upper endoscopy. Operative time and patient satisfaction were also recorded.
  
  
  RESULTS
  Between February 2004 and February 2007, a total of 123 patients underwent LNF, 59 (48.0%) SGV- and 64 (52.0%) SGV+. The 2 groups were statistically comparable. There was no significant difference about median DeMeester score, low esophageal sphincter resting pressure, and long-term satisfaction score between the 2 groups at a mean of 4 years of follow-up (range, 36 to 60 mo). The mean operative time was statistically significantly lower in the SGV- patients (90 vs. 115 min, P=0.04).
  
  
  CONCLUSIONS
  Our experience suggests that LNF without division of SGV provides a good clinical and functional outcome, whereas division of the SGV is associated with longer operative times.
authors.affiliation: General Surgery Department, University Hospital Madrid Monteprincipe, Madrid, Spain. ielpo.b@gmail.com
authors.forename: Benedetto
authors.initials: B
authors.lastname: Ielpo
authors.forename: Pedro
authors.initials: P
authors.lastname: Martin
authors.forename: Ricardo
authors.initials: R
authors.lastname: Vazquez
authors.forename: Ramon
authors.initials: R
authors.lastname: Corripio
authors.forename: Juan
authors.initials: J
authors.lastname: San Roman
authors.forename: Felipe
authors.initials: F
authors.lastname: Acedo
authors.forename: Fernando
authors.initials: F
authors.lastname: La Puente
authors.forename: Antonio
authors.initials: A
authors.lastname: Torres
authors.forename: Gianpiero
authors.initials: G
authors.lastname: Gravante
authors.forename: Vicente
authors.initials: V
authors.lastname: Fernandez-Nespral
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013270:Stomach / Q000098:blood supply* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*