F. Pozo et al., Clinical efficacy of the Toupet technique performed by laparoscopic surgery - Medium-term follow-up in 122 cases, SURG ENDOSC, 15(10), 2001, pp. 1171-1174
Citations number
20
Categorie Soggetti
Surgery
Journal title
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES
Background: We present the results obtained in a series of patients with ga
stroesophageal reflux disease (GERD) who underwent the same type of laparos
copic surgery (Toupet technique).
Methods: A total of 122 patients with symptomatic hiatal hernia and GERD we
re submitted to laparoscopic surgery between March 1993 and March 1999, In
all patients, we performed a preoperative gastroduodenal radiological study
, an upper gastrointestinal (GI) endoscopy, esophageal manometry, and 24-h
pH monitoring. The same studies were repeated at 3 months. All patients wer
e followed up clinically for greater than or equal to1 year. The only lapar
oscopic technique used was the Toupet (270 degrees posterior fundoplication
).
Results: In 117 patients (95.9%), the clinical results were good, with comp
lete disappearance of the symptoms. Two patients suffered a relapse, which
was resolved by reintervention with laparoscopy. One patient experienced dy
sphagia and frequent chest pain for 5 months. Another two patients had mode
rate difficulty in belching. The endoscopic and radiological barium studies
at 3 months were normal in all patients. Significant differences were seen
in functional studies performed prior to and 3 months after the operation
in all patients (p < 0.05).
Conclusions: Surgical laparoscopic treatment with the Toupet technique is e
ffective both clinically and functionally. In cases of relapse, a new repai
r is possible with laparoscopy. Long-term follow-up of these patients is ne
cessary to show whether these results are maintained over time.