Symptomatic Outcome of Laparoscopic Fundoplication, Using a Minimal Dissection Technique

Abstract

Background and Aims: The symptomatic outcome of 135 consecutive patients operated laparoscopically for gastro-oesophageal reflux disease (GORD) by a minimal paraoesophageal dissection technique is reported. Patients and Methods: At a median (range) follow-up time of 25 months (6–82 months) we sent the patients a self-assessment questionnaire regarding symptomatic outcome of the operation. Results: Median (range) operation time was 65 minutes (33–185 minutes). Per- and postoperative complications occurred in four patients (3 %). There were no conversions and no mortality. The answering rate was 91 %. Of all patients, 87 % were free of reflux symptoms, 84 % without any medication, 99 % reported at least improvement, 90 %–95 % reported persistence of favourable outcome, 90 % were satisfied, 91 % scored the outcome as good or excellent, and 95 % of the patients were ready to recommend the operation to family or friend. However, 31 % reported dysphagia and 76 % troublesome gas bloating, causing problems in 24 % of the patients. No association between different outcome variables and crural repair could be shown. Conclusion: Laparoscopic fundoplication can be done in a simple and fast way, with minimal morbidity, short hospital stay and without compromising outcome. Nevertheless, the operation is seldom without some sequel for the patient.