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https://hdl.handle.net/2440/41851
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Type: | Journal article |
Title: | Laparoscopic anterior 90° fundoplication for reflux or large hiatus hernia |
Other Titles: | Laparoscopic anterior 90 degrees fundoplication for reflux or large hiatus hernia |
Author: | Shukri, M. Watson, D. Lally, C. Devitt, P. Jamieson, G. |
Citation: | ANZ Journal of Surgery, 2008; 78(3):123-127 |
Publisher: | Blackwell Science Asia |
Issue Date: | 2008 |
ISSN: | 1445-1433 1445-2197 |
Statement of Responsibility: | Mohammed J. Shukri, David I. Watson, Carolyn J. Lally, Peter G. Devitt and Glyn G. Jamieson |
Abstract: | Anterior 90° 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° 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° 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. |
Keywords: | Anterior partial fundoplication Gastro-oesophageal reflux Laparoscopy |
DOI: | 10.1111/j.1445-2197.2007.04385.x |
Published version: | http://dx.doi.org/10.1111/j.1445-2197.2007.04385.x |
Appears in Collections: | Aurora harvest Surgery publications |
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