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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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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
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author Althar, Robert A.
author_facet Althar, Robert A.
author_sort Althar, Robert A.
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description 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.
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spelling pubmed-30153192011-02-17 Laparoscopic Anti-Reflux Surgery in the Community Hospital Setting: Evaluation of 100 Consecutive Patients Althar, Robert A. JSLS Scientific Papers 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. Society of Laparoendoscopic Surgeons 1999 /pmc/articles/PMC3015319/ /pubmed/10444008 Text en © 1999 by JSLS, Journal of the Society of Laparoendoscopic Surgeons. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Scientific Papers
Althar, Robert A.
Laparoscopic Anti-Reflux Surgery in the Community Hospital Setting: Evaluation of 100 Consecutive Patients
title Laparoscopic Anti-Reflux Surgery in the Community Hospital Setting: Evaluation of 100 Consecutive Patients
title_full Laparoscopic Anti-Reflux Surgery in the Community Hospital Setting: Evaluation of 100 Consecutive Patients
title_fullStr Laparoscopic Anti-Reflux Surgery in the Community Hospital Setting: Evaluation of 100 Consecutive Patients
title_full_unstemmed Laparoscopic Anti-Reflux Surgery in the Community Hospital Setting: Evaluation of 100 Consecutive Patients
title_short Laparoscopic Anti-Reflux Surgery in the Community Hospital Setting: Evaluation of 100 Consecutive Patients
title_sort laparoscopic anti-reflux surgery in the community hospital setting: evaluation of 100 consecutive patients
topic Scientific Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3015319/
https://www.ncbi.nlm.nih.gov/pubmed/10444008
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