Laparoscopic Floppy Nissen Fundoplication

Background Some studies suggest that obesity is associated with a poor outcome after Laparoscopic Nissen Fundoplication (LNF), whereas others have not replicated these findings. The effect of body mass index (BMI) on the short- and long-term results of LNF is investigated. Methods Inclusion criteria were only patients who undergone a LNF with at least 11-year follow-up data available, patients with preoperative weight and height data available for calculation of BMI (Kg/m2), and patients with a BMI up to a maximum of 34.9. Results 201 patients met the inclusion criteria: 43 (21.4%) had a normal BMI, 89 (44.2%) were overweight, and 69 (34.4%) were obese. The operation was significantly longer in obese patients; the use of drains and graft was less in the normal BMI group (p < 0.0001). The hospital stay, conversion (6,4%), and intraoperative and early postoperative complications were not influenced by BMI. Conclusions BMI does not influence short-term outcomes following LNF, but long-term control of reflux in obese patients is worse than in normal weight subjects.

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Section: Introductionmentioning

confidence: 99%

Short- and Long-Term, 11–22 Years, Results after Laparoscopic Nissen Fundoplication in Obese versus Nonobese Patients

et al. 2017

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“…This technique has been described previously. [ 5 11 ] The patients who underwent surgery for a hiatal hernia (type I and type III) underwent a procedure that entailed dissection of the hernia sac, reduction of the hernial sac and its contents from the mediastinum into the abdominal cavity. The posterior hiatal repair was routinely performed.…”

Section: Methodsmentioning

confidence: 99%

“…The availability of laparoscopic antireflux surgery (LARS) has changed the threshold for referring patients to surgery. Several studies have reported excellent short-[ 4 ] and long-term[ 5 ] results for this procedure. Some studies have already shown that the benefits of a shorter hospital stay and reduced post-operative morbidity associated with laparoscopic techniques for anti-reflux surgery also apply to elderly patients.…”

Section: Introductionmentioning

confidence: 99%

Short- and long-term results after laparoscopic floppy Nissen fundoplication in elderly versus non-elderly patients

et al. 2020

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Background: Laparoscopic anti-reflux surgery could be of benefit in a subset of elderly patients with gastroesophageal reflux disease. However, there are few reports that have evaluated the long-term results. This study examined the effects of age on the short- and long-term (for at least 5 years) outcomes after laparoscopic Nissen fundoplication (LNF). Patients and Methods: Patients were divided into four groups as follows: young (18–49); adult (50–69); and elderly (70–84), and very elderly (85–91). The database (recorded prospectively) included operating duration, conversion, intra- and early post-operative complication and late outcomes. Mean follow-up was 14.5 years (range 5–24 years). Results: Five hundred and sixty-nine patients met the inclusion criteria: young n = 219 (38.4%); adult n = 248 (43.5%); elderly n = 91 (16.0%) and very elderly n = 11 (1.9%). Hiatal hernia (type I and III) was significantly less frequent in young and adult patients ( P < 0.0001). The operation was significantly longer in elderly and very elderly patients ( P < 0.001); the use of drains ( P < 0.001) and grafts ( P < 0.0001) for hiatal hernia repair was less in young and adult patients. The hospital stay, conversion (5.4%), intra-operative and early post-operative complications were not influenced by age. Dysphagia was evenly distributed among the groups. Forty-eight (8.4%) patients had recurrence: 15 in the young group (6.8%), 18 in the adult group (7.2%), 11 in the elderly group (12%) and 4 in the very elderly group (36.3%) ( P < 0.0001). Conclusions: Age does not influence short- and long-term outcomes following LNF. Control of reflux in the elderly is worse than adult patients. Therefore, ageing is a relative contraindication to LNF.

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“…ГПОД составляют 98 % всех грыж диафрагмы, а в 50 % случа-ев не вызывают никаких клинических проявлений и, следовательно, не диагностируются [3]. Несмотря на достижения в хирургии пищевода, этот раздел остает-ся одним из наиболее проблемных [4,5].…”

Section: Introductionunclassified

Досвід Хірургічного Лікування Гриж Стравохідного Отвору Діафрагми Лапароскопічним Доступом

Ratchik¹,

Prolom²,

Shevchenkо³

et al. 2021

GASTRO

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Laparoscopic Floppy Nissen Fundoplication

Abstract: LFNF is an effective long-term treatment for gastroesophageal reflux disease, yielding similar results to open fundoplication.

Cited by 12 publications

References 33 publications

Short- and Long-Term, 11–22 Years, Results after Laparoscopic Nissen Fundoplication in Obese versus Nonobese Patients

Short- and Long-Term, 11–22 Years, Results after Laparoscopic Nissen Fundoplication in Obese versus Nonobese Patients

Short- and long-term results after laparoscopic floppy Nissen fundoplication in elderly versus non-elderly patients

Досвід Хірургічного Лікування Гриж Стравохідного Отвору Діафрагми Лапароскопічним Доступом

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