Lap. Nissen fundoplication leads to better respiratory symptom control than Toupet in the long term of 20 years

© 2023. The Author(s)..

INTRODUCTION: Having performed anti-reflux surgery for thirty years, it was important to reexamine our patients in the long term to enlarge the body of evidence concerning classical and extraesophageal symptoms that are differently controlled by Nissen or Toupet fundoplication.

OBJECTIVES: We report a cohort of 155 GERD patients who underwent fundoplication within a tailored approach between 1994 and 2000. Changes in the perioperative functional outcome, GERD symptoms, and quality of life are being analyzed 10 and 20 years after the operation.

RESULTS: The operation resulted in a superior quality of life compared to a patient cohort treated with PPI therapy. We found that both surgical methods (laparoscopic Nissen fundoplication and laparoscopic Toupet fundoplication) cure classical symptoms equally (heartburn, regurgitation, and dysphagia). GERD patients receiving a Toupet fundoplication seem more likely to suffer from extraesophageal GERD symptoms 10 and 20 years after surgery than patients with a Nissen fundoplication. On the other hand, some patients with Nissen fundoplication report dysphagia even 10 and 20 years after surgery.

CONCLUSION: Both the laparoscopic Nissen and Toupet fundoplications provide excellent symptom control in the long term. Moreover, the Nissen fundoplication seems to be superior in controlling extraesophageal reflux symptoms, but at the expense of dysphagia. In summary, tailoring the operation based on symptoms seems advantageous.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:408

Enthalten in:

Langenbeck's archives of surgery - 408(2023), 1 vom: 22. Sept., Seite 372

Sprache:

Englisch

Beteiligte Personen:

Gehwolf, Philipp [VerfasserIn]
Agerer, Teresa [VerfasserIn]
Stacul, Nadine [VerfasserIn]
Kienzl-Wagner, Katrin [VerfasserIn]
Schäfer, Aline [VerfasserIn]
Berchtold, Valeria [VerfasserIn]
Cakar-Beck, Fergül [VerfasserIn]
Elisabeth, Gasser [VerfasserIn]
Wykypiel, Heinz [VerfasserIn]

Links:

Volltext

Themen:

Deglutition disorders
Fundoplication
Gastroesophageal reflux
Heartburn
Humans
Journal Article
Laparoscopy
Quality of life

Anmerkungen:

Date Completed 25.09.2023

Date Revised 21.01.2024

published: Electronic

Citation Status MEDLINE

doi:

10.1007/s00423-023-03108-8

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM362343934