Comparison of outcomes of open versus laparoscopic Nissen fundoplication performed in a single practice.

Abstract:

BACKGROUND:We reviewed Nissen fundoplications performed in a single practice from January 1989 to March 1997, encompassing our transition from open to laparoscopic procedures. Because all operations were done by two surgeons in the same two hospitals, the study is well controlled for comparisons. METHODS:Records of 271 consecutive patients were reviewed. RESULTS:From 1989 to 1992 all patients underwent open fundoplication (n = 78). Thereafter, with increasing frequency, laparoscopic fundoplication was performed. The laparoscopic group was slightly younger (48 +/- 14 years) than the open group (54 +/- 13 years), but gender distribution and body mass index (BMI) did not differ. Mean operating time for laparoscopic cases was 163 +/- 58 minutes compared with 148 +/- 59 minutes for open cases (NS). Intraoperative complication rate was 8% for both groups. Length of hospitalization was shorter for patients undergoing laparoscopic surgery (2.4 days versus 7.2 for open procedures, P <0.05). In follow-up, 82% of the open Nissen group were asymptomatic compared with 84% of the laparoscopic Nissen group. The same proportion of patients required reoperation for dysphagia (3% for each group). Of patients who had the open procedure, 21% had wound complications. None of those treated laparoscopically had long-term morbidity from trocar insertion sites. CONCLUSION:Equal effectiveness in treating reflux combined with shorter hospitalization and absence of wound complications makes the laparoscopic approach the preferred method for performing fundoplication.

journal_name

Am J Surg

authors

Eshraghi N,Farahmand M,Soot SJ,Rand-Luby L,Deveney CW,Sheppard BC

doi

10.1016/S0002-9610(98)00049-X

subject

Has Abstract

pub_date

1998-05-01 00:00:00

pages

371-4

issue

5

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(98)00049-X

journal_volume

175

pub_type

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