Prospective evaluation of laparoscopic and open 360o fundoplication in mild and severe gastro-oesophageal reflux disease
2002 (English)In: European Journal of Surgery, ISSN 1102-4151, Vol. 168, no 10, 539-545 p.Article in journal (Refereed) Published
To investigate the relationship between five-year control of reflux and early postoperative oesophageal function after total fundoplication done either laparoscopically or through a laparotomy in severe and mild reflux disease.
Prospective open study.
University hospital, Sweden.
In the group with severe disease 9 patients had a laparotomy and 7 laparoscopy. The corresponding figures for the group with mild disease were 21 and 34 respectively.
The increase in lower oesophageal sphincter pressure 6 months after operation in patients with recurrent disease was significantly less than that for patients with good reflux control (p < 0.01). In patients who had laparotomy, including 30% (9/30) with severe reflux disease, good long-term reflux control was found in 93% (27/29). In patients operated on laparoscopically including 17% (7/41) with severe reflux disease good long-term reflux control was found in 90% (35/39).
The mechanism of recurrence differed between patients with severe disease who had a laparotomy and patients with mild disease operated on laparoscopically. Early postoperative manometry was prognostic for recurrence. Long-term reflux control seems to be similar after laparotomy and laparoscopy. Further randomised studies are needed.
Place, publisher, year, edition, pages
2002. Vol. 168, no 10, 539-545 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-24845PubMedID: 12666693Local ID: 9243OAI: oai:DiVA.org:liu-24845DiVA: diva2:245168