Laparoscopic treatment of gastroesophageal reflux disease. Personal experience

L. Novellino, M. Vitellaro, M. Longoni, M. Andretta, L. Spinelli, G. Faillace, A. Piazzini Albani, N. Giuzzi, L. Bottero, D. De Benedetti, L. Campanati, L. Bertulessi

Research output: Contribution to journalArticlepeer-review

Abstract

This paper represents our five-year experience in laparoscopic antireflux surgery. Seven-ynine patients underwent laparoscopic fundoplication: 32 Nissen, 41 Rossetti, 1 Dor and 5 Toupet. Digestive tract radiography, esophago-duodeno-gastroscopy, esophageal manometry and 24-hour Ph monitoring were performed during preoperative evaluation. Some patients also underwent scyntigraphy. During endoscopy stage I esophagitis was found in 27 patients (34%), stage II in 7 patients (9%), stage III in 3 patients (4%), Barrett's in 10 patients (13%); 32 patients (40%) were affected with gastroesophageal reflux disease without esophagitis. Our follow-up showed two complications (2.5%) that were reoperated. One month after surgery 17 patients (21%) showed dysphagia. Eleven (13.3%) had undergone Rossetti procedure and 6 (7.5%) Nissen's. Six months later, 13 patients (16%) were still symptomatic - 4 who underwent Nissen (5%) and 9 Rossetti (11%) procedures. Results showed one hiatal hernia recurrence, without reflux, after the Toupet procedure. Long-term follow-up mean 32 months (range 12 to 50) on 60 patients showed 58 patients Visick I (96%), 1 Visick II (2%) and 1 Visick III (2%). We are convinced that the laparoscopic approach to the esophago-gastric junction is better and provides a more detailed view than open surgery. The problem lies in the indication and choice of the right procedure to perform.

Original languageEnglish
Pages (from-to)77-80
Number of pages4
JournalGastroenterology International
Volume10
Issue numberSUPPL. 2
Publication statusPublished - 1997

Keywords

  • GERD
  • Laparoscopy
  • Surgery

ASJC Scopus subject areas

  • Gastroenterology

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