Original articleGeneral thoracicLaparoscopic Clam Shell Partial Fundoplication Achieves Effective Reflux Control With Reduced Postoperative Dysphagia and Gas Bloating
Section snippets
Patients and Methods
We reviewed our series of patients undergoing clam shell partial fundoplication operated on between November 2002 and May 2006. In all, 140 patients (82 female; mean age, 53 years) underwent laparoscopic clam shell procedure. This study was approved by the University of Pittsburgh Institutional Review Board. Because this was a retrospective review, individual consent was waived.
Ninety-four of these patients were referred to us for surgical management of medically recalcitrant gastroesophageal
Results
This clam shell hybrid of a standard Toupet and Dor fundoplication was safely and expediently performed. There was no need for intraoperative conversion to an open procedure to complete the antireflux surgical repair. Mean operative time was 45 minutes, with a range of 30 to 140 minutes. The average hospital stay was slightly less than 2 days, with a range of 1 to 5 days. Symptomatic relief of gastroesophageal reflux symptoms was noted in 95% during the period of follow-up. Gas bloating was
Comment
The primary goal of this report is to describe the technical details of a new partial fundoplication approach to symptomatic gastroesophageal reflux disease. This intermediate-term clinical evaluation of this dynamic, near-circumferential, clam shell like fundoplication has provided promising results.
Nissen fundoplication has a high long-term control of reflux, ranging from 85% to 95% [12]. Although its efficacy is well documented in terms of gastroesophageal reflux control, the postoperative
References (15)
- et al.
Management of paraesophageal hernia
Surg Clin North Am
(2005) - et al.
Partial versus complete fundoplication: is there a correct answer?
Surg Clin North Am
(2005) - et al.
Laparoscopic Toupet fundoplication is an inadequate procedure for patients with severe reflux disease
J Gastrointest Surg
(1999) - et al.
Effect of Nissen fundoplication on gastric motor and sensory functions
J Pediatr Gastroenterol Nutr
(2006) - et al.
Assessment of quality of life after laparoscopic Nissen fundoplication in patients with gastroesophageal reflux disease
World J Surg
(2007) - et al.
Quality of life following laparoscopic anterior 90° versus Nissen fundoplication: results from a multicenter randomized trial
World J Surg
(2006) - Landreneau RJ, el-Sherif AE, Luketich JD. Modified Toupet fundoplication with anterior Dor flap: the curly fry...
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