Laparoscopic Nissen fundoplication with anterior versus posterior hiatal repair: long-term results of a randomized trial

Abstract Background Postoperative dysphagia in patients after Nissen fundoplication might be related to the technique used for the closure of the esophageal hiatus. Methods A total of 102 patients with gastroesophageal reflux were randomized to undergo laparoscopic Nissen fundoplication with either...

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Bibliographic Details
Published in:The American journal of surgery 2008, Vol.195 (1), p.61-65
Main Authors: Wijnhoven, Bas P.L., M.D., Ph.D, Watson, David I., M.D., F.R.A.C.S, Devitt, Peter G., M.S., F.R.A.C.S, Game, Philip A., M.B.B.S., F.R.A.C.S, Jamieson, Glyn G., M.S., F.R.A.C.S
Format: Article
Language:English
Subjects:
Biological and medical sciences
Deglutition Disorders - etiology
Digestive system. Abdomen
Dysphagia
Endoscopy
Fundoplication
Fundoplication - adverse effects
Gastroesophageal Reflux - surgery
General aspects
Hernia, Hiatal - surgery
Hernias
Hiatal repair
Humans
Investigative techniques, diagnostic techniques (general aspects)
Laparoscopy
Medical sciences
Nissen
Questionnaires
Randomized trial
Surgery
Treatment Outcome
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Summary:Abstract Background Postoperative dysphagia in patients after Nissen fundoplication might be related to the technique used for the closure of the esophageal hiatus. Methods A total of 102 patients with gastroesophageal reflux were randomized to undergo laparoscopic Nissen fundoplication with either anterior (47 patients) or posterior (55 patients) repair of the diaphragmatic hiatus. Results Clinical data at 5 years after surgery were available for 96% of patients enrolled in the trial. There was no significant difference between the 2 techniques for symptoms of dysphagia at the 5-year follow-up evaluation, although more patients who underwent posterior hiatal repair underwent further surgery for dysphagia-related symptoms (8 vs 2). Better control of heartburn was achieved in patients in the anterior hiatal repair group. Patients from both groups were equally satisfied with the overall outcome after surgery. Conclusions At the 5-year follow-up evaluation, there was no significant difference in dysphagia between anterior closure and posterior hiatal repair.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2006.12.046