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Short-term outcome after laparoscopic and open 360 degrees fundoplication - A prospective randomized clinical trial

Wenner, Jörgen LU ; Nilsson, G.; Öberg, Stefan LU ; Melin, T.; Larsson, Sylvia LU and Johnsson, Folke LU (2001) In Surgical Endoscopy 15(10). p.1124-1128
Abstract
Background: Despite the lack of randomized trials supporting the laparoscopic approach, laparoscopic antireflux surgery has gained widespread acceptance during the last decade. The aim of this study was to compare the short-term symptomatic and objective outcome after laparoscopic and open 360 degrees fundoplication in a prospective randomized clinical trial. Methods: Sixty patients with GERD were randomized to undergo either laparoscopic (LF) or open 360 degrees fundoplication (OF). Endoscopy, esophageal manometry, 24-h pH monitoring, clinical symptom evaluation, and symptom scoring according to a validated questionnaire (the Gastrointestinal Symptom Rating Scale [GSRS]) was performed preoperatively and 6 months after surgery. Results:... (More)
Background: Despite the lack of randomized trials supporting the laparoscopic approach, laparoscopic antireflux surgery has gained widespread acceptance during the last decade. The aim of this study was to compare the short-term symptomatic and objective outcome after laparoscopic and open 360 degrees fundoplication in a prospective randomized clinical trial. Methods: Sixty patients with GERD were randomized to undergo either laparoscopic (LF) or open 360 degrees fundoplication (OF). Endoscopy, esophageal manometry, 24-h pH monitoring, clinical symptom evaluation, and symptom scoring according to a validated questionnaire (the Gastrointestinal Symptom Rating Scale [GSRS]) was performed preoperatively and 6 months after surgery. Results: Five patients randomized to the laparoscopic group were converted to open surgery. Esophageal acid exposure was restored to normal in all patients. Lower esophageal sphincter length and resting pressure were significantly increased after both laparoscopic and open fundoplication (p < 0.001); there were no differences between the groups. No significant differences were seen in symptomatic outcome, although there was a trend toward a higher rate of mild dysphagia (p = 0.051) after laparoscopic surgery. GSRS revealed a decrease in reflux score (p < 0.001) and abdominal pain score (p < 0.001) postoperatively. There were no significant differences in GSRS scores between the two groups. Conclusion: Laparoscopic 360 degrees fundoplication is as effective in treating reflux disease as open fundoplication. Six months postoperatively, no significant differences were seen in symptomatic or objective outcome. Long-term evaluation is needed. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Surgical Endoscopy
volume
15
issue
10
pages
1124 - 1128
publisher
Springer
external identifiers
  • wos:000171410700016
  • scopus:0034810259
ISSN
0930-2794
DOI
10.1007/s00464-001-9043-4
language
English
LU publication?
yes
id
5fabb359-fec7-498a-987b-8855896f1c6b (old id 1118777)
date added to LUP
2008-07-18 13:49:40
date last changed
2018-01-07 08:57:02
@article{5fabb359-fec7-498a-987b-8855896f1c6b,
  abstract     = {Background: Despite the lack of randomized trials supporting the laparoscopic approach, laparoscopic antireflux surgery has gained widespread acceptance during the last decade. The aim of this study was to compare the short-term symptomatic and objective outcome after laparoscopic and open 360 degrees fundoplication in a prospective randomized clinical trial. Methods: Sixty patients with GERD were randomized to undergo either laparoscopic (LF) or open 360 degrees fundoplication (OF). Endoscopy, esophageal manometry, 24-h pH monitoring, clinical symptom evaluation, and symptom scoring according to a validated questionnaire (the Gastrointestinal Symptom Rating Scale [GSRS]) was performed preoperatively and 6 months after surgery. Results: Five patients randomized to the laparoscopic group were converted to open surgery. Esophageal acid exposure was restored to normal in all patients. Lower esophageal sphincter length and resting pressure were significantly increased after both laparoscopic and open fundoplication (p &lt; 0.001); there were no differences between the groups. No significant differences were seen in symptomatic outcome, although there was a trend toward a higher rate of mild dysphagia (p = 0.051) after laparoscopic surgery. GSRS revealed a decrease in reflux score (p &lt; 0.001) and abdominal pain score (p &lt; 0.001) postoperatively. There were no significant differences in GSRS scores between the two groups. Conclusion: Laparoscopic 360 degrees fundoplication is as effective in treating reflux disease as open fundoplication. Six months postoperatively, no significant differences were seen in symptomatic or objective outcome. Long-term evaluation is needed.},
  author       = {Wenner, Jörgen and Nilsson, G. and Öberg, Stefan and Melin, T. and Larsson, Sylvia and Johnsson, Folke},
  issn         = {0930-2794},
  language     = {eng},
  number       = {10},
  pages        = {1124--1128},
  publisher    = {Springer},
  series       = {Surgical Endoscopy},
  title        = {Short-term outcome after laparoscopic and open 360 degrees fundoplication - A prospective randomized clinical trial},
  url          = {http://dx.doi.org/10.1007/s00464-001-9043-4},
  volume       = {15},
  year         = {2001},
}