title: A comparative study of laparoscopic and open Nissen fundoplication for GERD in Georgia.
abstract: OBJECTIVE
  The study compares and analyzes the effectiveness and outcomes of open A. Chernousov modified Nissen fundoplication (CMNF) and laparoscopic total fundoplication in Georgia for gastroesophageal reflux disease (GERD) concerning perioperative course, postoperative complications, symptomatic relief, recurrent disease and the need for reinterventional surgery.
  
  
  METHODS
  A prospective randomized trial was performed. Twohundred fortythree patients with GERD were randomized, 123 patients underwent open CMNF procedure and 120 patients of laparoscopic total fundoplication. Pre- and postoperative tests included endoscopy, X-Ray, patient questionnaire (GERD - HQRL scale) and clinical assessment. Patients were followed for 10 years.
  
  
  RESULTS
  This prospective randomized trial showed good and excellent long-term results after open and laparoscopic total fundoplication for GERD (92,7% vs 88,5% respectively) (p=0,03). After open CMNF procedure there were 3 cases of postoperative ventral hernia, 9 cases of mild dysphagia. There was no recurrence. After laparoscopic approach there were 7 cases of solid and transient dysphagia, 3 cases of hard stenosis of cardiacs caused by wrap. There were 2 cases of recurrence, 3 cases of reflux and 1 case of epigastral trocar hernia.
  
  
  CONCLUSIONS
  In Georgia as well as throughout the world laparoscopic total fundoplication at the present time is the preferred method of choice for the treatment of GERD. It has best cosmetic effect, less pain and wound problems, shorter hospital stay, early return to work. Open CMNF is safe and effective procedure too. It prevents slippage syndrome and is characterized by better control of reflux and less frequency of recurrence and guarantees slightly better long-term functional results.
  
  
  BACKGROUND
  Antireflux surgery, GERD, Modified Nissen fundoplication, Prospective randomized trial.
authors.forename: Merab
authors.initials: M
authors.lastname: A Kiladze
authors.forename: Shalva
authors.initials: S
authors.lastname: T Giuashvili
authors.forename: Merab
authors.initials: M
authors.lastname: M Kiladze
authors.forename: David
authors.initials: D
authors.lastname: V Elgandashvili
mesh_terms: D003680:Deglutition Disorders / Q000209:etiology; D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000601:surgery*; D005846:Georgia (Republic); D006547:Hernia / Q000209:etiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D012086:Reoperation; D012307:Risk Factors; D016896:Treatment Outcome