title: Laparoscopic floppy Nissen fundoplication: 11-year follow-up.
abstract: BACKGROUND
  There are few published reports on the outcomes of ≥ 10 years after a laparoscopic floppy Nissen fundoplication (LFNF).
  
  
  METHODS
  From April 1994 to January 2012, 567 patients underwent LFNF and the outcomes of 211 cases were determined (from April 1994 to October 2000).
  
  
  RESULTS
  Outcomes at ≥ 11 years after surgery was available for 178 patients (84.3%) of which 167 (93.8%) had no heartburn or mild heartburn, 8 (4.5%) had moderate heartburn, and 3 had (1.7%) severe heartburn. Dysphagia was nonexistent or mild in 153 (85.9%), whereas the remaining 14.1% presented moderate to severe symptoms. Reports of 69.1% patients showed none or mild symptoms of abdominal bloating, that of 23% patients showed moderate discomfort, and reports of 7.8% showed severe bloating. Satisfaction score was 8.6 (of 10). A further surgical procedure was required for 7 patients (3.9%): 4 for recurrent reflux and 3 for dysphagia (2 for a tight wrap and 1 for a tight esophageal hiatus). Postoperative dysphagia sufficient for an endoscopic dilatation was observed in 4 patients (2.3%), where 3 were successfully managed with a single dilatation procedure and the last patient underwent several dilatations before adequate swallowing.
  
  
  CONCLUSIONS
  LFNF is an effective long-term treatment for gastroesophageal reflux disease, yielding similar results to open fundoplication.
authors.affiliation: Department of Surgery, University of L'Aquila, Italy. schietroma2001@yahoo.it
authors.forename: Mario
authors.initials: M
authors.lastname: Schietroma
authors.forename: Fabiola
authors.initials: F
authors.lastname: De Vita
authors.forename: Francesco
authors.initials: F
authors.lastname: Carlei
authors.forename: Sergio
authors.initials: S
authors.lastname: Leardi
authors.forename: Beatrice
authors.initials: B
authors.lastname: Pessia
authors.forename: Federico
authors.initials: F
authors.lastname: Sista
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Amicucci
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D016896:Treatment Outcome