title: Incidence and predisponent factors for the migration of the fundoplication by Nissen-Rossetti technique in the surgical treatment of GERD.
abstract: BACKGROUND
  Gastroesophageal reflux is the gastrointestinal tract disease most frequently find nowadays. The Nissen-Rossetti fundoplication is widely used for the surgical treatment, and intrathoracic migration of the valve is the most frequent complication.
  
  
  OBJECTIVE
  To assess the incidence of the fundoplication and its risk factors.
  
  
  METHODS
  Were analyzed retrospectively medical records of 207 patients undergoing laparoscopic fundoplication by the Nissen-Rossetti technique for the treatment of reflux disease. The variables analyzed were: sex, age, esophagitis grade, size of the herniation, enlargement of the cardia and esophageal shortening. For quantitative variables, was considered the Student's t test. For the nominal, was considered the chi-square or Fisher's exact test. P values ​​<0.05 were considered statistically significant.
  
  
  RESULTS
  Of the total, 135 were women (65.22%) and 72 men (34.78%) with mean age of 47.43 years. The size of the hernia varied between 2 and 6 cm. Two hundred patients had esophagitis (96.62%) and 113 (56.50%) grade I, 75 grade II (37.50%) and 12 grade III or IV (6%). Enlargement of the cardia and Barrett's esophagus were seen in 153 (73.91%) and 13 (6.28%) cases, respectively. One patient had esophageal shortening. Among women, 33 (24.4%) showed migration and among men, only six (8.3%) (p = 0.005). The average age of patients with and without migration was 54.03 and 45.89 years, respectively (p = 0.001).
  
  
  CONCLUSIONS
  The incidence of the fundoplication migration was 18.8%. The gender (female) and higher age influence the probability of migration. The degree of esophagitis, size of hernia and enlargement of the cardia were not risk factors for intrathoracic migration of the fundoplication.
authors: Faculdade Evangélica do Paraná, Curitiba, PR, Brasil. paulonassif@terra.com.br
authors: Paulo Afonso Nunes
authors: PA
authors: Nassif
authors: Lucas Eduardo
authors: LE
authors: Pedri
authors: Priscila Reis
authors: PR
authors: Martins
authors: Marcelo Morikuni
authors: MM
authors: Foauni
authors: Marcel da Silva
authors: Mda S
authors: Justen
authors: Michelle
authors: M
authors: Varaschim
authors: Denise Serpa
authors: DS
authors: Bopp
authors: Osvaldo
authors: O
authors: Malafaia
mesh_terms: D000328:Adult; D000368:Aged; D015984:Causality; D004868:Equipment Failure; D005260:Female; D005548:Foreign-Body Migration / Q000453:epidemiology*; D018662:Fundoplication / Q000295:instrumentation* / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult