Long-Term Results of Laparoscopic Nissen Fundoplication Due to Gastroesophageal Reflux Disease. A Ten Year Follow-Up in a Low Volume Center

Abstract

Background and Aims: Laparoscopic 360° Nissen fundoplication has been our routine surgical procedure since 1995, in the treatment of gastroesophageal reflux disease (GERD). We have reviewed our results of patients treated with laparoscopic Nissen fundoplication (LNF) during 1995–1998. Material and Methods: 170 patients have undergone LNF in our hospital since 1995. During the period of 1995–1998, 33 patients were treated. All patients were asked to return a structured follow-up questionnaire, using a Visick grading scale, after an average of 69 months (2003) and 117 months (2007). 29 questionnaires (90%) were answered in 2003, and 31 questionnaires (97%) were answered in 2007. One patient died at home before the first questionnaire in 2003, and is therefore not included. We present our results on LNF after an observation time of 117 months (range 99–144 months). Results: Patient satisfaction after LNF is rated as very good or good (Visick 1–2) in 93% in 2003 and 97% in 2007. 97% of the patients would recommend the same treatment to other patients with similar symptoms at ten year follow up. One patient has undergone resurgery during follow up. Daily gas bloat and flatulence is reported in 52% in 2003 and 39% in 2007, and is the most common reason for reduced satisfaction. Five patients report of reflux symptoms, one patient daily and four patients sometimes, where the first patient still uses proton pump inhibitor (PPI) daily and three patients use PPI occasionally. Conclusions: Patient satisfaction after LNF treatment for GERD is high at long-term (10 years) follow-up. Bloating and flatulence persistently occurred to a great extent and the need for preoperative information regarding these symptoms is important.