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Laparoscopic Nissen fundoplication: operative results and short-term follow-up.

Publication ,  Journal Article
Bittner, HB; Meyers, WC; Brazer, SR; Pappas, TN
Published in: Am J Surg
January 1994

The operative results, outcome, and short-term follow-up after laparoscopic exploration for Nissen fundoplication were evaluated in 35 patients with symptomatic gastroesophageal reflux and reflux-induced pulmonary disease. There were 19 female and 16 male patients, ranging in age from 17 to 72 years (mean: 42 years, SD: 11.6 years). In 20 patients, the symptoms were predominantly of regurgitation and heartburn; the remaining 15 patients had mixed regurgitation/heartburn and pulmonary symptoms. All patients underwent 24-hour pH monitoring, upper endoscopy, and manometry. The indication for surgery was medical failure or the need for long-term medical management with omeprazole. The operation, which was performed laparoscopically, is identical to the conventional Nissen fundoplication. There was a mortality rate of 0% and a morbidity rate of 25.7%. Five patients required conversion to open Nissen fundoplication, which was due to hemodynamic instability secondary to presumed pneumothorax in three patients and colotomy and a distal esophageal perforation in the other two patients. Thirty patients underwent laparoscopic Nissen fundoplication. Three patients developed early dysphagia, and one patient experienced a perforation of the piriform sinus due to nasogastric tube manipulation under anesthesia. All these patients had an uncomplicated postoperative course, and there was no long-term disability. The total surgical time of laparoscopic Nissen fundoplication was on average 107 minutes (SD: 35.3 minutes). Discharge usually occurred on the evening of postoperative day 2 (mean: 3.3 days; SD: 1.5 days). Twenty-six of the 30 patients who underwent laparoscopic Nissen fundoplication described the outcome as excellent and good (87%); however, 4 patients (13%) were unsatisfied. Fifteen patients (50%) had difficulty belching or vomiting, and moderate dysphagia was described by 7 patients (24%) in follow-up. Regurgitation and heartburn were cured in 96%, whereas reflux-induced pulmonary disease was cured in 50%. The results of laparoscopic Nissen fundoplication compare favorably with those of conventional Nissen fundoplication with respect to mortality, complications, and outcome.

Duke Scholars

Published In

Am J Surg

DOI

ISSN

0002-9610

Publication Date

January 1994

Volume

167

Issue

1

Start / End Page

193 / 198

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Suture Techniques
  • Surgery
  • Postoperative Complications
  • Male
  • Lung Diseases
  • Laparoscopy
  • Humans
  • Gastroesophageal Reflux
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Bittner, H. B., Meyers, W. C., Brazer, S. R., & Pappas, T. N. (1994). Laparoscopic Nissen fundoplication: operative results and short-term follow-up. Am J Surg, 167(1), 193–198. https://doi.org/10.1016/0002-9610(94)90073-6
Bittner, H. B., W. C. Meyers, S. R. Brazer, and T. N. Pappas. “Laparoscopic Nissen fundoplication: operative results and short-term follow-up.Am J Surg 167, no. 1 (January 1994): 193–98. https://doi.org/10.1016/0002-9610(94)90073-6.
Bittner HB, Meyers WC, Brazer SR, Pappas TN. Laparoscopic Nissen fundoplication: operative results and short-term follow-up. Am J Surg. 1994 Jan;167(1):193–8.
Bittner, H. B., et al. “Laparoscopic Nissen fundoplication: operative results and short-term follow-up.Am J Surg, vol. 167, no. 1, Jan. 1994, pp. 193–98. Pubmed, doi:10.1016/0002-9610(94)90073-6.
Bittner HB, Meyers WC, Brazer SR, Pappas TN. Laparoscopic Nissen fundoplication: operative results and short-term follow-up. Am J Surg. 1994 Jan;167(1):193–198.
Journal cover image

Published In

Am J Surg

DOI

ISSN

0002-9610

Publication Date

January 1994

Volume

167

Issue

1

Start / End Page

193 / 198

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Suture Techniques
  • Surgery
  • Postoperative Complications
  • Male
  • Lung Diseases
  • Laparoscopy
  • Humans
  • Gastroesophageal Reflux