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1: J Am Coll Surg. 2003 Jan;196(1):51-7; discussion 57-8; author reply 58-9.
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Five-year comprehensive outcomes evaluation in 181 patients after laparoscopic Nissen fundoplication.

Anvari M, Allen C.

Centre for Minimal Access Surgery and Department of Medicine, St Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.

BACKGROUND: We conducted an objective followup of 181 patients after laparoscopic Nissen fundoplication during a 5-year period after surgery. STUDY DESIGN: Patients underwent 24-hour pH recording, esophageal manometry, and symptom score assessment for six gastroesophageal reflux disease symptoms preoperatively and at 6 months, 2 years, and 5 years after surgery. RESULTS: Laparoscopic fundoplication was associated with a significant (p < 0.0001) increase in lower esophageal sphincter pressure and a significant (p < 0.0001) drop in duration of acid reflux in 24 hours, and symptom score, 6, 24, and 60 months after surgery when compared with preoperative values. Twenty-one patients (12%) have experienced recurrence of reflux-type symptoms, but only six have required repeat surgery. Lower esophageal sphincter tone dropped between 6 months and 5 years after surgery, but was still an effective antireflux barrier. Patient satisfaction with surgery dropped over the 5-year followup but remained high, at 86%, after 5 years. CONCLUSIONS: Laparoscopic Nissen fundoplication remains an effective antireflux procedure at 5 years. Copyright 2003 by the American College of Surgeons

PMID: 12517549 [PubMed - indexed for MEDLINE]