Randomized Trial of Division Versus Nondivision of Short Gastric Vessels During Nissen Fundoplication

Kinsey-Trotman, Stephen P.; Devitt, Peter G.; Bright, Tim; Thompson, Sarah K.; Jamieson, Glyn G.; Watson, David I.

doi:10.1097/sla.0000000000002648

Cited by 29 publications

(27 citation statements)

References 22 publications

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“…High rates of dysphagia are reported shortly after surgery, possibly due to oedema at the gastro‐oesophageal junction . However, at long‐term follow‐up, dysphagia rates in our cohort were low, being only 3–6%, which is in line with other studies . Bloating, flatulence and inability to belch are more commonly reported, with rates up to 50% .…”

Section: Discussionsupporting

confidence: 89%

“…Bloating, flatulence and inability to belch are more commonly reported, with rates up to 50% . Although such inconvenience does not seem to depend on the type of fundoplication performed, a recent study showed that the division of the short gastric vessels significantly increased the frequency of bloating …”

Section: Discussionmentioning

confidence: 99%

“…30 However, at long-term follow-up, dysphagia rates in our cohort were low, being only 3-6%, which is in line with other studies. 4,6,[15][16][17] Bloating, flatulence and inability to belch are more commonly reported, with rates up to 50%. 12,17 Although such inconvenience does not seem to depend on the type of fundoplication performed, a recent study showed that the division of the short gastric vessels significantly increased the frequency of bloating.…”

Section: Discussionmentioning

confidence: 99%

“…12,17 Although such inconvenience does not seem to depend on the type of fundoplication performed, a recent study showed that the division of the short gastric vessels significantly increased the frequency of bloating. 15 We used the SF-36 as a generic and the QOLRAD as a diseasespecific instrument for QoL measurements. 21,25 The European Association of Endoscopic Surgery recommended these validated QoL instruments at the time our study began.…”

Section: Discussionmentioning

confidence: 99%

“…However, several studies have demonstrated improved quality of life (QoL), patient satisfaction and symptom control when following up patients to 20 years after surgery. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] A variety of instruments for measuring QoL occur in the literature. [20][21][22][23][24][25] Some studies combine reports of post-surgical symptoms and QoL.…”

Section: Introductionmentioning

confidence: 99%

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Quality of life and gastric acid‐suppression medication 20 years after laparoscopic fundoplication

Campanello

Westin

Unosson

et al. 2019

ANZ Journal of Surgery

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Background Laparoscopic fundoplication is an effective treatment for gastro‐oesophageal reflux disease (GERD). We aimed to assess quality of life (QoL), long‐term residual symptoms, patient satisfaction and use of acid‐suppression medication at 5, 10 and 20 years after surgery. Methods We identified a cohort of 100 patients who underwent laparoscopic fundoplication between 1993 and 1998. The validated QoL questionnaires Short Form health survey (SF‐36), and Quality‐of‐Life in Reflux and Dyspepsia (QOLRAD), as well as a specific questionnaire regarding post‐fundoplication symptoms, were sent to the patients at 5, 10 and 20 years after surgery. Furthermore, patients who reported using the acid‐suppression medication after 20 years were interviewed by telephone regarding their reason for taking it. Results Eighty‐eight percent of the patients responded at 5 and 10 years post‐surgery. Twenty years following fundoplication, 68 (84% of those still alive) patients completed the questionnaires. The patients had equivalent health‐related QoL scores in both the QOLRAD and SF‐36 questionnaires after 10 and 20 years, and those scores were in line with a Swedish age‐matched population. After 20 years, 87% were satisfied with the results, and 84% of the patients would recommend reflux surgery to a relative or a friend. At the telephone interview, 32% (22/68) confirmed using acid‐suppression medication, but only half (11/68) used it because of reflux symptoms. Conclusion The long‐term, satisfying outcomes in GERD symptoms and QoL 5 and 10 years after surgery were maintained at a 20‐year follow‐up. Half of the patients used acid‐suppression medication for reasons other than GERD symptoms.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quality of life and gastric acid‐suppression medication 20 years after laparoscopic fundoplication

Campanello

Westin

Unosson

et al. 2019

ANZ Journal of Surgery

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Long-term follow-up of two randomized trials comparing laparoscopic Nissen 360° with anterior 90° partial fundoplication

Hopkins

Irvine

Jamieson

et al. 2019

British Journal of Surgery

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Background: The side-effects of Nissen fundoplication have led to modifications, including partial fundoplications such as an anterior 90 ∘ wrap. Five-year follow-up of two randomized trials suggested fewer side-effects following anterior 90 ∘ partial fundoplication, but better reflux control after Nissen fundoplication. However, longer-term outcomes have not been reported. This study combined data from previous trials to determine 10-year outcomes.Methods: From 1999 to 2003, 191 patients were enrolled in two randomized trials comparing anterior 90 ∘ partial versus Nissen fundoplication. Trial protocols were similar, and data were combined to determine long-term clinical outcomes. Patients completed annual questionnaires assessing dysphagia, heartburn, medications, satisfaction and other symptoms. Visual analogue scales (0-10), a composite dysphagia score (0-45) and yes/no responses were used. Of the 191 patients, 152 (79⋅6 per cent) were available for 10-year follow-up. After anterior 90 ∘ fundoplication, patients reported less dysphagia to solids (score 2⋅03 versus 3⋅18 for the Nissen procedure; P = 0⋅037). Heartburn scores were lower after Nissen fundoplication (1⋅90 versus 2⋅83 for anterior 90 ∘ fundoplication; P = 0⋅035) and fewer patients required proton pump inhibitors (PPIs) (22 versus 39 per cent respectively; P = 0⋅035). Satisfaction scores were similar for both anterior 90 ∘ and Nissen groups (7⋅45 versus 7⋅36 respectively; P = 0⋅566), and the majority considered their original decision for surgery to be correct (86 versus 84 per cent; P = 0⋅818). Results:Conclusion: After 10 years, both procedures achieved similar success as measured by global satisfaction measures. Patients who had a Nissen fundoplication reported more dysphagia, whereas more heartburn and PPI consumption were reported after anterior 90 ∘ fundoplication. Registration numbers: ACTRN12607000298415 and ACTRN12607000304437 (http://www.anzctr.org.au/).

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Failed Antireflux Surgery

Winder,

Olafson,

Agcaoili

et al. 2023

Gastroesophageal Reflux Disease

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Randomized Trial of Division Versus Nondivision of Short Gastric Vessels During Nissen Fundoplication

Cited by 29 publications

References 22 publications

Quality of life and gastric acid‐suppression medication 20 years after laparoscopic fundoplication

Quality of life and gastric acid‐suppression medication 20 years after laparoscopic fundoplication

Long-term follow-up of two randomized trials comparing laparoscopic Nissen 360° with anterior 90° partial fundoplication

Failed Antireflux Surgery

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