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Laparoscopic Anti-Reflux Surgery in the Community Hospital Setting: Evaluation of 100 Consecutive Patients

BACKGROUND: Laparoscopic anti-reflux surgery has been shown to be superior to medical management for treatment of complicated gastroesophageal reflux disease (GERD). This study encompasses 100 consecutive patients undergoing laparoscopic Nissen-Rossetti or Toupet fundoplications for GERD refractory...

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Detalles Bibliográficos
Autor principal: Althar, Robert A.
Formato: Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 1999
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015319/
https://www.ncbi.nlm.nih.gov/pubmed/10444008
Descripción
Sumario:BACKGROUND: Laparoscopic anti-reflux surgery has been shown to be superior to medical management for treatment of complicated gastroesophageal reflux disease (GERD). This study encompasses 100 consecutive patients undergoing laparoscopic Nissen-Rossetti or Toupet fundoplications for GERD refractory to medical management. STUDY DESIGN: All 100 patients had failed maximum medical management (behavioral and dietary modifications, antacids, and H2 and acid PUMP blockers). All patients underwent esophagogastroduodenoscopy with biopsy prior to surgery. Ninety-eight patients had esophageal manometry to evaluate the lower esophageal sphincter pressures and determine the amplitude of contractions of the body of the esophagus. Twenty-four hour pH studies were used selectively when the preceding studies were equivocal. RESULTS: All 100 patients' surgeries were accomplished laparoscopically. The mortality rate was zero. The post-operative complication rate was 2%. The average hospital stay was 1.85 days. Follow-up was achieved in 98%. The mean follow-up was 17.6 months. All patients had significant improvement of their symptoms. No patients have long-term dysphagia. CONCLUSIONS: The study demonstrates that laparoscopic anti-reflux surgery can be safely and effectively accomplished in the community hospital setting.