Our Experience With Laparasopic Nissen Fundoplication in Patients With Gastroesophageal Reflux

M.tahir Oruc, MD, M. Umit Ugurlu, MD, H. Taner Turgut, MD, Emel Canbey, MD, Mehmet Ozyildiz, MD, Zehra Boyacioglu, MD. KOCAELI DERINCE TEACHING AND RESEARCH HOSPITAL GENERAL SURGERY CLINIC, KOCAELI, TURKEY

Background: Laparoscopic Fundoplication for gastroesophageal reflux disease (GERD) is common performed procedure in worldwide. We analyzed our laparoscopic Nissen Fundoplication (LNF) procedures performed in our clinic.
Methods: LNF was performed in 36 patients between January 2009- August 2011 in Kocaeli Derince Teaching and Research Hospital. Patients’ characteristics, operative and postoperative data were analyzed. Patients with GERD were reanalyzed with endoscopy and pH monitorization post-operatively in one month.
Results: Thirty-seven patients aged 42±9.4 (26-63) years old were enrolled the study 13 (35%) men and 24 (65%) women). The mean of body mass index was 26±3, and mean De Meester score of the patients was 53±39 (15-190). Mean duration of complaints for GERD was 4.7±3.9 (1-20) years. LNF were completed successfully in 33 (92%) of these patients. LNF alone was performed in 15 (43%) patients, whereas in 11 (30%) patients LNF and cruroplasty and in 10 patients LNF-cruroplasty with mesh repair were performed. Mean operation time was 64 ± 18.2 (35-130) minutes. In 2 patients (5.4%) laparoscopic approaches were turned into open procedure due to peroperative complications as esophageal perforation in one, subcutaneous emphysema and pneumothorax in another. These cases were within the first 10 surgeries and occurred in learning phase. Average time to discharge post-fundoplication was 2.6 days.
Conclusion: LNF is safe and effective in treatment of GERD. Other approaches such as cruroplasty and mesh repair might be added to LNF procedure due to concomitant pathologies to GERD. The clinical results show decrease in morbidity and hospitalization time. Our results are comparable to the published results and our clinic is one of the executive centers for LNF.

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