OUTCOMES OF LAPAROSCOPIC NISSEN FUNDOPLICATION FOR THE TREATMENT OF GASTROESOPHAGEAL REFLUX DISEASE
Main Article Content
Abstract
Background: Gastroesophageal reflux disease (GERD) is a common condition that significantly impacts patients' quality of life. While medical therapy, particularly proton pump inhibitors, remains the first-line treatment, a considerable number of cases fail to achieve symptom relief. For these patients, laparoscopic Nissen fundoplication has long been recognized as the gold standard surgical intervention. This study aims to evaluate the safety and efficacy of laparoscopic Nissen fundoplication in the management of GERD. Objectives: To assess the treatment outcomes of laparoscopic Nissen fundoplication in GERD patients at Can Tho General Hospital from 2023 to 2025. Materials and methods: This is an interventional clinical study without a control group, conducted on 34 patients diagnosed with GERD between January 2023 and April 2025. Patient selection was based on failure to respond to medical therapy and confirmation of GERD through clinical assessment and diagnostic tests. Results: The mean age of patients included in the study was 34.71 ± 8.93 years. Among them, 23 patients (67.6%) were male, and 11 patients (32.4%) were female. The average GERD-Q score was 14.26 ± 1.69. Intraoperative findings showed that 26 patients (76.5%) had a type I hiatal hernia. The mean operative time was recorded at 124.56 ± 27.37 minutes. Postoperative outcomes were favorable, with 32 patients (94.1%) achieving good results and 2 patients (5.9%) classified as fair outcomes. Conclusion: Laparoscopic Nissen fundoplication has proven to be a safe and effective treatment option for GERD patients who do not respond to medical therapy. The procedure demonstrates high success rates with minimal complications, reinforcing its role as the preferred surgical intervention for refractory GERD cases.
Keywords
GERD, laparoscopic Nissen fundoplication, anti-reflux surgery
Article Details
References
2. Hopkins R.J., Irvine T., Jamieson G.G., Devitt P.G. and Watson D.I. Long-term follow-up of two randomized trials comparing laparoscopic Nissen 360° with partial anterior 90° fundoplication. The British journal of surgery. 2020. 107(1),56-63, doi: 10.1002/bjs.11327.
3. Park S., Park S.H., Kim M.S., Kwak J., Lee I., et al. Exploring objective factors to predict successful outcomes after laparoscopic Nissen fundoplication. International journal of surgery (London, England). 2023.109(5),1239-1248, doi: 10.1097/JS9.0000000000000274.
4. Triệu Thị Bích Hợp, Nguyễn Đức Vượng. Đặc điểm lâm sàng, nội soi và các yếu tố nguy cơ bệnh trào ngược dạ dày thực quản ở bệnh nhân ngoại trú tại Bệnh viện Thiện Hạnh, tỉnh Đắk Lắk, năm 2022. Tạp chí Y học Việt Nam. 2022;513(1). doi: 10.51298/vmj.v513i1.2367
5. Trần Quốc Khánh, Nguyễn Thị Tâm. Đặc điểm lâm sàng, hình ảnh nội soi, mô hình học bệnh trào ngược dạ dày - thực quản tại Bệnh viện 199. Tạp chí Y học Việt Nam. 2023. 89(01), 4953, doi: 10.51298/vmj.v532i1B.7547.
6. Daus K.E., Farivar A.S., Bograd A.J., White P.T., Aye R.W., et al. Long-Term Outcomes of Magnetic Sphincter Augmentation: A Comparative Study to Nissen Fundoplication. The Annals of thoracic surgery. 2024. 118(6),1207-1214, doi: 10.1016/j.athoracsur.2024.09.010.
7. De Ponthaud C., Voron T. and Paye F. Laparoscopic floppy Nissen fundoplication with valve calibration: a safe and efficient procedure. Surgery today. 2024. 54(9), 1041-1050, doi: 10.1007/s00595-024-02817-x.
8. Callahan Z., Amundson J., Su B., Kuchta K. and Ujiki M. Outcomes after anti-reflux procedures: Nissen, Toupet, magnetic sphincter augmentation or anti-reflux mucosectomy? Surgical endoscopy. 2023. 37(5), 3944-3951, doi: 10.1007/s00464-022-09544-9.
9. Kim M.S., Oh Y., Lee J., Park J., Kim J., et al. Trends in laparoscopic anti-reflux surgery: a Korea nationwide study. Surgical Endoscopy. 2021. 35(8), 4241-4250, doi: 10.3390/medicina60030518.
10. He S., Jia Y., Xu F., Li Q., Xiong X., et al. Transient delayed gastric emptying following laparoscopic Nissen fundoplication for gastroesophageal reflux disease. Langenbeck's archives of surgery. 2021. 406, 1397-1405, doi: 10.1007/s00423-021-02209-4.
11. Yuce T.K., Ellis R.J., Merkow R.P., Soper N.J. and Bilimoria K.Y. Post-operative complications and readmissions following outpatient elective Nissen fundoplication. Surgical Endoscopy. 2020. 34(5), 2143-2148, doi: 10.1007/s00464-019-07020-5.
12. Zehetner J., Hoffsten J., Das S., Schoppmann S.F. and Lipham J.C. Looking back on a gold standard: a systematic literature review of laparoscopic Nissen fundoplication as an anti-reflux treatment option. European Surgery. 2024. 1-29, doi: 10.1007/s10353-024-00836-z.
13. Hoffsten J. and Forsell Y. Laparoscopic Nissen fundoplication versus 90° and 180° fundoplication for gastroesophageal reflux disease. European Surgery. 2022. 54, 66-73, doi: 10.1007/s10353-021-00745-5.