Aims: To evaluate retrospectively the outcome of laparoscopic
fundoplication in a cohort of patients with typical symptoms of
gastroesophageal reflux disease (GERD). Materials and Methods:
Forty-two patients with typical symptoms of GERD, who were operated for
laparoscopic Nissen's fundoplication from March 2001 to August 2008,
were studied. The study was limited to patients with positive findings
on upper gastrointestinal (GI) endoscopy done by us and "typical"
symptoms (heartburn, regurgitation, and dysphagia) of GERD.
Laparoscopic Nissen's fundoplication was performed when clinical
assessment suggested adequate oesophageal motility and length. Only one
patient who had negative endoscopic findings underwent a 24-h pH
monitoring before surgery. Outcome measures included assessment of the
relief of the primary symptom responsible for surgery in the early
postoperative period; the patient's evaluation of outcome, and quality
of life after surgery. Results: Relief of the primary symptom
responsible for surgery was achieved in 95.24% of patients at a mean
follow-up of 28 months. Thirty-five patients were asymptomatic, two had
minor gastrointestinal symptoms not requiring medical therapy, three
patients had gastrointestinal symptoms requiring medical therapy/Proton
Pump Inhibitors (PPI) and in two patients the symptoms worsened after
surgery. There were no deaths. Clinically significant complications
occurred in six patients. Median hospital stay was 3 days, decreasing
from 6 days in the first 10 patients to 3 days in the last 10 patients.
Conclusions: Laparoscopic Nissen's fundoplication is the choice of
operation for clinically symptomatic GERD patients
