Tj. Heikkinen et al., Comparison of laparoscopic and open Nissen fundoplication 2 years after operation - A prospective randomized trial, SURG ENDOSC, 14(11), 2000, pp. 1019-1023
Citations number
24
Categorie Soggetti
Surgery
Journal title
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES
Background: Laparoscopic operation has replaced the conventional open proce
dure in the treatment of gastroesophageal reflux disease (GERD) in spite of
the fact that longterm results based on controlled clinical trials have be
en lacking. The objective of this study was to compare outcome, quality of
life, and patient satisfaction after laparoscopic and open Nissen fundoplic
ation in a community hospital setting with a 2-year follow-up.
Methods: Forty-two patients with GERD were randomized to either laparoscopi
c (LNF) or open (ONF) Nissen fundoplication. Outcome evaluation included re
flux symptoms, gastrointestinal quality of life (GIQLI), and upper GI endos
copy.
Results: Esophagitis was cured among all patients in the LNF group and in 9
0% of the ONF group. There were two patients (10%) in both groups who had m
edicine-dependent recurrent reflux together with significant worsening in t
he GIQLI scores. One patient in the LNF group has been reoperated due to a
suture granuloma in the left epigastric port. Two patients in the LNF group
needed esophageal dilatation due to persistent dysphagia, GIQLI scores (sc
ale, 0-144) were equally normalized in both groups. Overall, 90% in the LNF
and 100% in the ONF group were either satisfied or very satisfied with the
operation. There was only one patient (LNF) who would not choose to have t
he operation again.
Conclusions: Laparoscopic and open Nissen fundoplication seem to be equally
effective methods for improving reflux symptoms and quality of life, resul
ting in a high rate of satisfaction among patients with an intermediate fol
low-up period of 2 years.