AN OBJECTIVE ASSESSMENT OF LAPAROSCOPIC ANTIREFLUX SURGERY

Citation
Dm. Sataloff et al., AN OBJECTIVE ASSESSMENT OF LAPAROSCOPIC ANTIREFLUX SURGERY, The American journal of surgery, 174(1), 1997, pp. 63-67
Citations number
27
Categorie Soggetti
Surgery
ISSN journal
00029610
Volume
174
Issue
1
Year of publication
1997
Pages
63 - 67
Database
ISI
SICI code
0002-9610(1997)174:1<63:AOAOLA>2.0.ZU;2-X
Abstract
BACKGROUND: Complicated gastroesophageal reflux disease (GERD) require s long-term medical therapy, which in some instances is incompletely e ffective or poorly tolerated, Additionally, there is concern about the consequences of prolonged acid suppression therapy, Surgical correcti on of GERD has been a therapeutic option for decades, With the advent of video-assisted laparoscopic surgery, antireflux surgery has had a r esurgence in popularity. PATIENTS AND METHODS: Between October 1992 an d June 1995, 20 patients who underwent laparoscopic antireflux surgery were completely studied preoperatively and 3 months postoperatively w ith 24-hour pH monitoring and esophageal manometry. Follow-up averaged 18 months, The indication for surgery was medically refractory diseas e in 75%, intolerance to medication in 10%, and concern regarding the consequences of long-term medical therapy in 15%, Two thirds of these patients had complicated GERD. RESULTS: Operative time averaged 4 hour s, There was no conversion to an open procedure, There was no mortalit y, Two patients had recurrent reflux, for a failure rate of 10%, Overa ll, postoperative reflux episodes and percent of time pH was less than 4 dropped significantly, Lower esophageal sphincter function showed a statistically significant increase in mean postoperative resting pres sure and residual sphincter pressure during swallowing. There was no c hange in motility postoperatively. CONCLUSIONS: Laparoscopic antireflu x surgery is a safe, effective, therapeutic alternative in the managem ent of gastroesophageal reflux disease, (C) 1997 by Excerpta Medica, I nc.