Ten-year results of a randomized clinical trial of laparoscopic total fundoplication with or without division of the short gastric vessels
- 17 November 2008
- journal article
- research article
- Published by Oxford University Press (OUP) in British Journal of Surgery
- Vol. 96 (1), 61-65
- https://doi.org/10.1002/bjs.6393
Abstract
Background Total fundoplication is the most common antireflux operation and can be performed with or without division of the short gastric vessels. There seems to be no difference in short-term outcomes with either approach. The aim of the study was to determine whether there were the long-term differences (after 10 years). Methods Ninety-nine patients were enrolled in the study. Short gastric vessels were divided in 52 patients (group 1) and left intact in 47 (group 2). Ten patients were lost to follow-up and seven patients died, leaving 42 patients for analysis in group 1 and 40 in group 2. All patients were evaluated by standardized quality of life questionnaires. Results Three patients underwent reoperation within 5 years. Thirty-eight of 42 patients with a completely mobilized fundus reported no reflux symptoms, compared with 31 of 40 patients with intact vessels. There were no differences between the groups in other symptoms reflecting postfundoplication complaints and quality of life outcomes. Conclusion When total fundoplication is performed it makes no difference whether the fundus is mobilized or not. Both types of repair provide lasting control of reflux.Keywords
This publication has 19 references indexed in Scilit:
- Esophageal impedance–pH monitoringDigestive and Liver Disease, 2008
- Levels of evidence available for techniques in antireflux surgeryDiseases of the Esophagus, 2007
- Clinical results of laparoscopic fundoplication at ten years after surgerySurgical Endoscopy, 2005
- Mechanical consequences of short gastric vessel division at the time of laparoscopic total fundoplicationJournal of Gastrointestinal Surgery, 2004
- Randomized trial to study the effect of fundic mobilization on long-term results of Nissen fundoplicationBritish Journal of Surgery, 1999
- Dysphagia After Laparoscopic Antireflux SurgeryAnnals of Surgery, 1996
- Mechanisms of Gastric and Esophageal Perforations During Laparoscopic Nissen FundoplicationAnnals of Surgery, 1996
- Fate of Nissen fundoplication after 20 years. A clinical, endoscopical, and functional analysis.Gut, 1993
- Post-fundoplication SymptomsAnnals of Surgery, 1983
- Evaluation of Current Operations for the Prevention of Gastroesophageal RefluxAnnals of Surgery, 1974