Early experience with laparoscopic antireflux surgery in the rural setting

Background. Gastroesophageal reflux (GERD) affects a significant portion of the population, and refractory or untreated disease can have serious longt erm complications. Antireflux procedures are now done more frequently becau se of advances in laparoscopic technique. It has been reported in the liter ature that the quality of care is better in larger urban hospitals than in smaller facilities. We report our experience with laparoscopic antireflux s urgery in a 35-bed rural county hospital. Methods. We reviewed the charts of 26 patients who had a laparoscopic antir eflux procedure in our facility during a 2-year period. Data from the preop erative evaluation, the operative procedure, and the postoperative period w ere recorded. The patients had office follow-up after the procedure and als o were contacted at the time of the study to evaluate their outcome. Results. Ninety-five percent of the patients had excellent symptomatic reli ef from heartburn and required no medication at follow-up. There was no mor tality. Our complication rate was 7%, and the conversion rate to laparotomy was 7%. Most patients were discharged on the day after the procedure. Conclusion. Laparoscopic antireflux procedures can effectively relieve symp toms of GERD with minimal morbidity and mortality The outcome of our initia l experience in a small rural facility is analogous to results previously p ublished in the literature.