20 years later: laparoscopic fundoplication durability View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-09

AUTHORS

Ben Robinson, Christy M. Dunst, Maria A. Cassera, Kevin M. Reavis, Ahmed Sharata, Lee L. Swanstrom

ABSTRACT

BACKGROUND: Laparoscopic surgery for gastrointestinal reflux disease was introduced in 1991. Early safety, efficacy, and 5-10-year durability have been amply documented, but long-term patient outcomes have been criticized. This study presents 20-year outcomes after laparoscopic fundoplication (LF) in a consecutive patient cohort. METHODS: Patients who underwent primary LF procedures for gastroesophageal reflux disease (GERD) were identified from a prospectively collected IRB-approved database (1991-1995). A phone symptom questionnaire was administered using a 5-point validated GERD scoring system (heartburn, regurgitation, and dysphagia). Symptomatic success was defined by a lack of surgical re-intervention and a low symptom score. RESULTS: One-hundred and ninety-three patients were identified during the time period. Fifty-one patients completed the survey (100 lost to follow-up, 40 deceased, 2 declined to answer). Respondents had a median follow-up of 19.7 years. Overall, 38/51 (74.5%) of patients reported complete control of heartburn and regurgitation. Ten patients reported only occasional heartburn. Eight of fifty-one (16%) reported daily dysphagia, and 22/51 (43%) of respondents were using proton pump inhibitors at the time of telephone interview. Nine of fifty-one (18%) underwent revision of the original surgery which did not negatively impact the satisfaction rating, with 8/9 (89%) of these patients reporting the highest satisfaction rating. Overall, 46/51 (90%) were satisfied with their choice of surgery. CONCLUSION: Long-term results from the early experience with LF are excellent with 94% of patients reporting only occasional or fewer reflux symptoms at 20-year follow-up. However, 18% required surgical revision surgery to maintain their results. There is a relatively high rate of daily dysphagia but 90% of patients are happy to have had LF. More... »

PAGES

2520-2524

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-014-4012-x

DOI

http://dx.doi.org/10.1007/s00464-014-4012-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1020631496

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25487547


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