Laparoscopic Anterior 180° Partial Fundoplication - Indian Perspective
Aim: To evaluate Laparoscopic anterior 180° partial fundoplication for its good long-term relief for symptoms of gastroesophageal reflux disease and association with adverse effects.
Study design: Prospectively evaluated case series.
Settings: Tertiary care centers
Patients: The clinical outcomes were determined for all patients who had undergone a laparoscopic anterior partial fundoplication by us between January 1, 2013 to March 31, 2021.
Interventions: Clinical outcome, complications, and follow-up after laparoscopic anterior 180° partial fundoplication was obtained using a structured questionnaire.
Results and Discussion: 228 procedures were performed. The outcome at 0 to 8 years (mean, 4 years) follow-up was determined for 195 patients. 1 death was linked to the laparoscopic procedure and 2 patients died during follow-up due to unrelated causes. For 186 patients (95%) with clinical outcome data at late follow-up, gastroesophageal reflux symptoms were significantly improved following surgery and were well controlled in 9 patients (4.5%). In a subset of 85 patients with more than 5 years of follow-up, relief of heartburn was found in 59 patients (69%). Incidence and severity of heartburn were reduced after surgery in 22 patients (26%), decreased dyspepsia in 80 patients (94%). Normal belching was preserved in 84 patients (99%) and almost all patients were able to eat normally.
Conclusion: Laparoscopic anterior 180° partial fundoplication is an effective procedure for the surgical treatment of gastroesophageal reflux and is associated with a high rate of patient satisfaction at late follow-up. Compared to Nissen's fundoplication it is as good as control of recurrent reflux as well as reduced adverse effects. The patient goes home in 3-4 days. Hence we recommend it as the procedure of choice for reflux symptoms.
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