Abstract
Conclusions: To date, it has been difficult to compare medical therapy for gastroesophageal reflux disease with that of surgical management from a scientific viewpoint, mainly because of the lack of standardization of the operative technique. This study was designed to identify a methodology for standardization of surgical technique and to measure the effectiveness of this standardization. Methods: Surgeons contributing to a major international multicenter trial comparing optimum medical therapy with surgical therapy for treatment of gastroesophageal reflux attempted to optimize their surgical techniques so that a realistic comparison could be made that may aid clinical decision-making. The surgeons met, shared their techniques using video, and produced a standardized set of criteria for the surgical centers and a common operative technique. Data collection methods ensured accuracy of the records of the procedure applied and the data were analyzed for consistency with set surgical standards. Results: There was a high degree of conformity (>95%) between the recommended method of performing a Nissen fundoplication as defined in the trial protocol, and variations were restricted to isolated individuals. The operations were completed without mortality, few conversions, and with very low postoperative morbidity. Conclusions: This study has shown that, contrary to commonly held belief, surgeons are able to standardize their work for the purposes of measuring the outcome of an operative procedure within the context of a randomized, controlled trial.
| Original language | English |
|---|---|
| Pages (from-to) | 995-998 |
| Number of pages | 4 |
| Journal | World Journal of Surgery |
| Volume | 32 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 2008 |
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ASJC Scopus subject areas
- Surgery
Cite this
Standardization of surgical technique in antireflux surgery : The LOTUS trial experience. / Attwood, Stephen E A; Lundell, Lars; Ell, Christian; Galmiche, Jean Paul; Hatlebakk, Jan; Fiocca, Roberto; Lind, Tore; Eklund, Stefan; Junghard, Ola.
In: World Journal of Surgery, Vol. 32, No. 6, 06.2008, p. 995-998.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Standardization of surgical technique in antireflux surgery
T2 - The LOTUS trial experience
AU - Attwood, Stephen E A
AU - Lundell, Lars
AU - Ell, Christian
AU - Galmiche, Jean Paul
AU - Hatlebakk, Jan
AU - Fiocca, Roberto
AU - Lind, Tore
AU - Eklund, Stefan
AU - Junghard, Ola
PY - 2008/6
Y1 - 2008/6
N2 - Conclusions: To date, it has been difficult to compare medical therapy for gastroesophageal reflux disease with that of surgical management from a scientific viewpoint, mainly because of the lack of standardization of the operative technique. This study was designed to identify a methodology for standardization of surgical technique and to measure the effectiveness of this standardization. Methods: Surgeons contributing to a major international multicenter trial comparing optimum medical therapy with surgical therapy for treatment of gastroesophageal reflux attempted to optimize their surgical techniques so that a realistic comparison could be made that may aid clinical decision-making. The surgeons met, shared their techniques using video, and produced a standardized set of criteria for the surgical centers and a common operative technique. Data collection methods ensured accuracy of the records of the procedure applied and the data were analyzed for consistency with set surgical standards. Results: There was a high degree of conformity (>95%) between the recommended method of performing a Nissen fundoplication as defined in the trial protocol, and variations were restricted to isolated individuals. The operations were completed without mortality, few conversions, and with very low postoperative morbidity. Conclusions: This study has shown that, contrary to commonly held belief, surgeons are able to standardize their work for the purposes of measuring the outcome of an operative procedure within the context of a randomized, controlled trial.
AB - Conclusions: To date, it has been difficult to compare medical therapy for gastroesophageal reflux disease with that of surgical management from a scientific viewpoint, mainly because of the lack of standardization of the operative technique. This study was designed to identify a methodology for standardization of surgical technique and to measure the effectiveness of this standardization. Methods: Surgeons contributing to a major international multicenter trial comparing optimum medical therapy with surgical therapy for treatment of gastroesophageal reflux attempted to optimize their surgical techniques so that a realistic comparison could be made that may aid clinical decision-making. The surgeons met, shared their techniques using video, and produced a standardized set of criteria for the surgical centers and a common operative technique. Data collection methods ensured accuracy of the records of the procedure applied and the data were analyzed for consistency with set surgical standards. Results: There was a high degree of conformity (>95%) between the recommended method of performing a Nissen fundoplication as defined in the trial protocol, and variations were restricted to isolated individuals. The operations were completed without mortality, few conversions, and with very low postoperative morbidity. Conclusions: This study has shown that, contrary to commonly held belief, surgeons are able to standardize their work for the purposes of measuring the outcome of an operative procedure within the context of a randomized, controlled trial.
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UR - http://www.scopus.com/inward/citedby.url?scp=43949110241&partnerID=8YFLogxK
U2 - 10.1007/s00268-007-9409-4
DO - 10.1007/s00268-007-9409-4
M3 - Article
C2 - 18224465
AN - SCOPUS:43949110241
VL - 32
SP - 995
EP - 998
JO - World Journal of Surgery
JF - World Journal of Surgery
SN - 0364-2313
IS - 6
ER -