PMID- 12739117
OWN - NLM
STAT- MEDLINE
DCOM- 20040628
LR  - 20181113
IS  - 1432-2218 (Electronic)
IS  - 0930-2794 (Linking)
VI  - 17
IP  - 8
DP  - 2003 Aug
TI  - Effectiveness of laparoscopic fundoplication in relieving the symptoms of 
      gastroesophageal reflux disease (GERD) and eliminating antireflux medical 
      therapy.
PG  - 1200-5
AB  - BACKGROUND: Recent reports have suggested that antireflux surgery should not be 
      advised with the expectation of elimination of medical treatment. We reviewed our 
      results with laparoscopic fundoplication as a means of eliminating the symptoms 
      of gastroesophageal reflux disease (GERD), improving quality of life, and freeing 
      patients from chronic medical treatment for GERD. METHODS: A total of 297 
      patients who underwent laparoscopic fundoplication (Nissen, n = 252; Toupet, n = 
      45) were followed for an average of 31.4 months. Preoperative evaluation included 
      endoscopy, barium esophagram, esophageal manometry, and 24-h pH analysis. A 
      preoperative and postoperative visual analogue scoring scale (0-10 severity) was 
      used to evaluate symptoms of heartburn, regurgitation, and dysphagia. A GERD 
      score (2-32) as described by Jamieson was also utilized. The need for GERD 
      medications before and after surgery was assessed. RESULTS: At 2-year follow-up, 
      the average symptom scores decreased significantly in comparison to the 
      preoperative values: heartburn from 8.4 to 1.7, regurgitation from 7.2 to 0.7, 
      and dysphagia from 3.7 to 1.0. The Jamieson GERD score also decreased from 25.7 
      preoperatively to 4.1 postoperatively. Only 10% of patients were on proton pump 
      inhibitors (PPI) at 2 years after surgery for typical GERD symptoms. A similar 
      percentage of patients (8.7%) were on PPI treatment for questionable reasons, 
      such as Barrett's esophagus, "sensitive" stomach, and irritable bowel syndrome. 
      Seventeen patients (5.7%) required repeat fundoplication for heartburn ( n = 9), 
      dysphagia ( n = 5), and gas/bloating ( n = 3). CONCLUSIONS: Laparoscopic 
      fundoplication can successfully eliminate GERD symptoms and improve quality of 
      life. Significant reduction in the need for chronic GERD medical treatment 2 
      years after antireflux surgery can be anticipated.
FAU - Papasavas, P K
AU  - Papasavas PK
AD  - Minimally Invasive Surgical Program, West Perm Allegheny Health System, 4800 
      Friendship Ave., Pittsburgh, PA 15212, USA. ppapasav@wpahs.org
FAU - Keenan, R J
AU  - Keenan RJ
FAU - Yeaney, W W
AU  - Yeaney WW
FAU - Caushaj, P F
AU  - Caushaj PF
FAU - Gagne, D J
AU  - Gagne DJ
FAU - Landreneau, R J
AU  - Landreneau RJ
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20030513
PL  - Germany
TA  - Surg Endosc
JT  - Surgical endoscopy
JID - 8806653
RN  - 0 (Antacids)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Antifoaming Agents)
RN  - 0 (Histamine H2 Antagonists)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antacids/therapeutic use
MH  - Anti-Ulcer Agents/therapeutic use
MH  - Antifoaming Agents/therapeutic use
MH  - Combined Modality Therapy
MH  - Deglutition Disorders/etiology
MH  - Female
MH  - Follow-Up Studies
MH  - Fundoplication/*methods
MH  - Gastroesophageal Reflux/complications/drug therapy/etiology/*surgery
MH  - Histamine H2 Antagonists/therapeutic use
MH  - Humans
MH  - *Laparoscopy
MH  - Male
MH  - Middle Aged
MH  - Pain/etiology
MH  - Pressure
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
RF  - 22
EDAT- 2003/05/10 05:00
MHDA- 2004/06/29 05:00
CRDT- 2003/05/10 05:00
PHST- 2002/03/14 00:00 [received]
PHST- 2002/10/18 00:00 [accepted]
PHST- 2003/05/10 05:00 [pubmed]
PHST- 2004/06/29 05:00 [medline]
PHST- 2003/05/10 05:00 [entrez]
AID - 10.1007/s00464-002-8910-y [doi]
PST - ppublish
SO  - Surg Endosc. 2003 Aug;17(8):1200-5. doi: 10.1007/s00464-002-8910-y. Epub 2003 May 
      13.