Clinical Outcome at 10 Years After Laparoscopic Versus Open Nissen Fundoplication

Ruíz-Tóvar, Jaime; Diez-Tabernilla, María; Chames, Alejandro; Morales, Vicente; Martínez-Molina, Enrique

doi:10.1089/lap.2009.0230

Cited by 21 publications

(12 citation statements)

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“…The value of laryngeal parameters of RFS in the evaluation of patient follow-up after anti-reflux surgery is not yet clear [11,12]. In our study, a reduction was detected in all parameters of RFS after surgery in both patient groups but in terms of the D value, only the total score and the decline in erythema/ hyperemia was found to be significant in the LPR group.…”

Section: Discussioncontrasting

confidence: 50%

“…In recent years, with the use of endoscopy and minimally invasive techniques, surgical methods have become more suitable as a treatment method compared to the lifetime use of drugs and have gained momentum. LARS has been quite successful at treating the typical symptoms of GERD but its effect on LPR symptoms remains controversial [11,12]. More data are needed regarding laryngeal symptoms, physical findings and changes in voice parameters after surgery.…”

Section: Introductionmentioning

confidence: 99%

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The effect of antireflux surgery on laryngeal symptoms, findings and voice parameters

Şahin

Vardar

Ersin

et al. 2015

Eur Arch Otorhinolaryngol

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The aim of this study was to evaluate the effect of laparoscopic antireflux surgery (LARS) on the laryngeal symptoms, physical findings and voice parameters of gastroesophageal reflux disease (GERD) patients with or without laryngopharyngeal reflux (LPR). Forty-one GERD patients predominantly with LPR symptoms (Group I) and twenty-six GERD patients without LPR symptoms (Group II) who had LARS were prospectively analysed before and 2 years after the surgery. Upper gastrointestinal endoscopy, 24-h ambulatory pH or MII-pH monitoring was performed in all cases. A reflux study group including specialists from five departments in a university hospital decided surgical indications. Patients were asked to fill out a validated LPR and voice quality questionnaire (Reflux Symptom Index and Voice Handicap Index-10). Laryngeal findings were evaluated and scored using a laryngoscopic grading scale [Reflux Finding Score (RFS)], by four blinded ENT specialists. GRBAS scale was done by a blinded otolaryngologist. Voice parameters were measured objectively via the Multi Dimensional Voice Programme (MDVP). The mean age was 45.8 ± 8.5 for Group I (24 men) and 48.9 ± 12.3 for Group II (16 men). The mean follow-up after LARS was 24.5 ± 1.3 months for Group I and 25.2 ± 1.1 months for Group II. The preoperative mean score of RSI was 22.8 ± 7.4 vs. 11.2 ± 6.6; RFS was 10.6 ± 2.3 vs. 5.7 ± 2.5 and VHI was 18.07 ± 4.4 vs. 10.86 ± 3.3 for Group I and II, respectively. The postoperative mean score of RSI was 12.9 ± 6.4 vs. 8.4 ± 4.5; RFS was 6.9 ± 2.0 vs. 4.5 ± 2.3 and VHI was 9.59 ± 4.4 vs. 7.95 ± 3.5 for Group I and II, respectively. Group I had significantly lower RSI and RFS scores following LARS compared to the preoperative scores. LARS successfully improved RFS, RSI and VHI in carefully selected patients with GERD, especially the signs and symptoms related to the larynx and voice. Although the indications for LARS are limited in patients with LPR symptoms, these results favor the decision-making period of LARS.

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Section: Discussioncontrasting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

The effect of antireflux surgery on laryngeal symptoms, findings and voice parameters

Şahin

Vardar

Ersin

et al. 2015

Eur Arch Otorhinolaryngol

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“…Lifelong medical therapy both complicates treatment compliance and increases cost. An alternative treatment alternative is antireflux surgery [4]. Laparoscopic antireflux surgery completely abolishes symptoms and reduces the need for medical therapy in a majority of patients [5].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Nissen fundoplication with mesh-hiatoplasty: Single center experience and early-term results

Kafadar¹,

Yalaza²,

Türkan³

et al. 2016

CIM

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Laparoscopic Nissen fundoplication with mesh-hiatoplasty: Single center experience and early-term results AbstractPurpose: In this study we report early-term results of laparoscopic Nissen fundoplication with mesh hiatoplasty that we perform to treat gastroesophageal reflux disease. Methods:We retrospectively reviewed the medical records of 68 patients who underwent laparoscopic Nissen fundoplication with mesh hiatoplasty at our clinic. Thirty-six (53%) patients were male and 32 (47%) were female. The mean age of the study population was 46.1 (25-72) years. All patients underwent endoscopy, esophagus pH metry and manometry before the operation. All operations were performed under general anesthesia using five ports. In addition to Nissen fundoplication, all patients also underwent polypropylene mesh placement.Results: Preoperatively, all patients reported a burning sensation in the chest and regurgitation of the stomach contents up into the mouth. The mean time from symptom onset to operation was 28 (6-84) months. All patients were diagnosed with esophagitis in the preoperative endoscopic examination. The mean operative time was 80 (40-125) minutes, the median duration of hospital stay was 1.2 (1-4) days and the median follow-up time was 12 (2-30) months. Functional outcome was excellent in 65% of patients, good in 24.5%, moderately good in 7% and poor in 3.5%. Conclusion:Fundoplication with mesh hiatoplasty is a surgical procedure performed for the traetment of gastroesophageal reflux disease and hiatal hernia. Surgery can be safely carried out with low morbidity and mortality rates and constitutes an alternative to long-term drug therapy. We believe that this operation is beneficial since it reduces the rate of recurrences to a significant degree.SUPPLEMENT

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“…Diğer tedavi alternatifi ise antireflü cerrahidir. Minimal invaziv yöntemlerin cerrahide yaygın kullanılmasıyla beraber, antireflü cerrahi de ömür boyu ilaç kullanımına kıyasla daha uygun bir tedavi alternatifi haline gelmiş, bu yöntemler kullanı-larak uygulandığında, ameliyat sonrası ağrı ve hastanede kalış süresinin azaldığı ortaya konmuştur [10]. Laparoskopik antireflü cerrahi, hastaların büyük bir kısmında semptomları tamamen iyileştirmekte ve medikal tedaviye gereksinimlerini azaltmaktadır [11].…”

Section: Discussionunclassified

Laparoscopic Nissen Fundoplication, Single Center Experience

Karaca¹

2015

Ann Clin Anal Med

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ÖzetAmaç: Gastroözofageal reflü hastalığının tedavisi için uyguladığımız Laparoskopik Nissen Fundoplikasyonu ameliyatlarının sonuçlarını değerlendirmek. Gereç ve Yöntem: Kliniğimizde Ocak 2008 ile Temmuz 2012 tarihleri arasın-da Laparoskopik Nissen Fundoplikasyonu uygulanan 81 hasta, geriye dönük olarak incelendi. Hastalardan 45'i kadın (%56), 36'si erkekti (%44). Ortalama yaş 40'tı (20-67). Hastaların tamamına ameliyat öncesinde en az 2 ay süre ile medikal tedavi verildi. Tüm hastalara ameliyat öncesi endoskopi ve özo-fagus biyopsisi yapıldı. Ameliyatlar genel anestezi altında 5 port kullanılarak yapıldı. Bulgular: Hastaların tamamında göğüste yanma ve mide içeriğinin ağza geri gelmesi şikâyetleri mevcuttu. Şikâyetlerin başlamasından ameliyata kadar geçen süre ortalama 12 aydı (4 ay-8 yıl). Ameliyat öncesi endoskopik incelemede bütün hastalarda özofajit tespit edildi. Histopatolojik incelemede, 6 hastada Barrett özofajiti saptandı. Ortalama ameliyat süresi 68 dakika (45-120 dk), ortanca hastanede kalış süresi 3 gün (1-7 gün) idi. Ortanca takip süresi 13 ay olarak belirlendi (7-40 ay). Bir hasta ilk ameliyatından 10 ay sonra nüks hiyatus fıtığı nedeniyle tekrar ameliyat edildi. Fonksiyonel sonuçlar hastaların %76'sında mükemmel, %14'ünde iyi, %10'unda orta olarak değerlendirildi. Tartışma: Laparoskopik Nissen Fundoplikasyonu, gastroözo-fageal reflü hastalığının tedavisinde, düşük morbidite ve mortalite oranı ile uygulanabilecek ve uzun süreli ilaç tedavisine alternatif, cerrahi bir girişimdir. Anahtar KelimelerNissen Fundoplikasyonu; Gastroözofageal Reflü Hastalığı Abstract Aim: Evaluate the outcomes of laparoscopic Nissen fundoplication surgery for the treatment of gastroesophageal reflux disease. Material and Method: Examined in our clinic, between January 2008 and July 2012 of 81 patients laparoscopic Nissen fundoplication administered retrospectively. 45 patients were female (56%) and 36 men (44%). Average age was 40 (20-67). Medical treatment was given to all patients for at least 2 months before the surgery. Endoscopy and esophageal biopsy was performed in all patients preoperatively. Operations were performed under general anesthesia, using 5 ports. Results: All patients, there were heartburn and stomach contents come into the mouth. The average time between the start of complaints surgery 12 months (range, 4 months-8 years). Endoscopic examination was detected esophagitis in all patients preoperatively. Barrett's esophagitis was found in 6 patients, histopathologic examination. Mean operative time was 68 min (45-120 min), and the median length of hospital stay 3 days (1-7 days). The median follow-up time was determined as 13 months (7-40 months). One patient was re-operated hiatus hernia recurrence of 10 months after the first surgery. The functional results were excellent in 76% of patients, 14% good, 10% as medium. Discussion: Laparoscopic Nissen fundoplication is a surgical initiative, the treatment of gastroesophageal reflux disease, with low morbidity and mortality rates can be applied, and an alter...

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Clinical Outcome at 10 Years After Laparoscopic Versus Open Nissen Fundoplication

Abstract: Laparoscopic Nissen fundoplication appears to be at least as safe and long term in effectiveness for GERD as the open approach, with the associated postoperative advantages of a minimally invasive access.

Cited by 21 publications

References 8 publications

The effect of antireflux surgery on laryngeal symptoms, findings and voice parameters

The effect of antireflux surgery on laryngeal symptoms, findings and voice parameters

Laparoscopic Nissen fundoplication with mesh-hiatoplasty: Single center experience and early-term results

Laparoscopic Nissen Fundoplication, Single Center Experience

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