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Laparoscopic anterior 90 degree fundoplication for reflux or large hiatus hernia.
ANZ J Surg. 2008 Mar; 78(3):123-7.AJ

Abstract

Anterior 90 degree partial fundoplication has been proposed as technique to minimize the risk of side-effects following surgery for gastro-oesophageal reflux. We have applied this approach for the treatment of gastro-oesophageal reflux and/or large hiatus hernias. Previous studies have shown that this type of procedure can achieve good control of reflux, with fewer side-effects. However, only short-term follow up has been reported. In this study, we determined later clinical outcomes in patients who have undergone this procedure. All patients who underwent a laparoscopic anterior 90 degree partial fundoplication surgery were identified from a database, which collected prospective clinical data. Patients completed a standardized questionnaire 3 months after surgery and then yearly to assess clinical symptoms of reflux and postoperative side-effects. Between February 1999 and January 2006, 246 patients underwent surgery--74 in conjunction with repair of a large hiatus hernia and 172 for reflux. Three patients underwent further surgery within 2 days of the original procedure (one for repair of a perforated oesophagus) and four underwent later surgical revision (reflux 3, dysphagia 1). Clinical follow-up data were available for 98% at 3-84 months (median 36). Most patients had effective relief of reflux symptoms at up to 3 years follow up. Dysphagia scores improved following surgery. The magnitude of this improvement was greater in patients with large hiatus hernias. More than 80% of the patients were able to belch normally at all time points after surgery and most were highly satisfied with the overall outcome. Satisfaction scores were higher following repair of a large hiatus hernia. The clinical results of laparoscopic anterior 90 degree fundoplication for either reflux or as part of repair of a large hiatus hernia are encouraging, although longer-term follow up is required to confirm durability of reflux control.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Shukri MJ
Department of Surgery, Flinders University, Flinders Medical Centre, Adelaide, South Australia, Australia.
Watson DI
No affiliation info available
Lally CJ
No affiliation info available
Devitt PG
No affiliation info available
Jamieson GG
No affiliation info available

MeSH

AgedAged, 80 and overFemaleFollow-Up StudiesFundoplicationGastroesophageal RefluxHernia, HiatalHumansLaparoscopyMaleMiddle AgedPatient SatisfactionPostoperative ComplicationsRegistriesRetrospective StudiesRisk AssessmentSeverity of Illness IndexSouth AustraliaTime FactorsTreatment Outcome

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18269472

Citation

Shukri, Mohammed J., et al. "Laparoscopic Anterior 90 Degree Fundoplication for Reflux or Large Hiatus Hernia." ANZ Journal of Surgery, vol. 78, no. 3, 2008, pp. 123-7.
Shukri MJ, Watson DI, Lally CJ, et al. Laparoscopic anterior 90 degree fundoplication for reflux or large hiatus hernia. ANZ J Surg. 2008;78(3):123-7.
Shukri, M. J., Watson, D. I., Lally, C. J., Devitt, P. G., & Jamieson, G. G. (2008). Laparoscopic anterior 90 degree fundoplication for reflux or large hiatus hernia. ANZ Journal of Surgery, 78(3), 123-7. https://doi.org/10.1111/j.1445-2197.2007.04385.x
Shukri MJ, et al. Laparoscopic Anterior 90 Degree Fundoplication for Reflux or Large Hiatus Hernia. ANZ J Surg. 2008;78(3):123-7. PubMed PMID: 18269472.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic anterior 90 degree fundoplication for reflux or large hiatus hernia. AU - Shukri,Mohammed J, AU - Watson,David I, AU - Lally,Carolyn J, AU - Devitt,Peter G, AU - Jamieson,Glyn G, PY - 2008/2/14/pubmed PY - 2008/3/28/medline PY - 2008/2/14/entrez SP - 123 EP - 7 JF - ANZ journal of surgery JO - ANZ J Surg VL - 78 IS - 3 N2 - Anterior 90 degree partial fundoplication has been proposed as technique to minimize the risk of side-effects following surgery for gastro-oesophageal reflux. We have applied this approach for the treatment of gastro-oesophageal reflux and/or large hiatus hernias. Previous studies have shown that this type of procedure can achieve good control of reflux, with fewer side-effects. However, only short-term follow up has been reported. In this study, we determined later clinical outcomes in patients who have undergone this procedure. All patients who underwent a laparoscopic anterior 90 degree partial fundoplication surgery were identified from a database, which collected prospective clinical data. Patients completed a standardized questionnaire 3 months after surgery and then yearly to assess clinical symptoms of reflux and postoperative side-effects. Between February 1999 and January 2006, 246 patients underwent surgery--74 in conjunction with repair of a large hiatus hernia and 172 for reflux. Three patients underwent further surgery within 2 days of the original procedure (one for repair of a perforated oesophagus) and four underwent later surgical revision (reflux 3, dysphagia 1). Clinical follow-up data were available for 98% at 3-84 months (median 36). Most patients had effective relief of reflux symptoms at up to 3 years follow up. Dysphagia scores improved following surgery. The magnitude of this improvement was greater in patients with large hiatus hernias. More than 80% of the patients were able to belch normally at all time points after surgery and most were highly satisfied with the overall outcome. Satisfaction scores were higher following repair of a large hiatus hernia. The clinical results of laparoscopic anterior 90 degree fundoplication for either reflux or as part of repair of a large hiatus hernia are encouraging, although longer-term follow up is required to confirm durability of reflux control. SN - 1445-2197 UR - https://www.unboundmedicine.com/medline/citation/18269472/Laparoscopic_anterior_90_degree_fundoplication_for_reflux_or_large_hiatus_hernia_ DB - PRIME DP - Unbound Medicine ER -