Original articleGeneral thoracicFifteen-Year Outcome of Laparoscopic and Open Nissen Fundoplication: A Randomized Clinical Trial
Section snippets
Patients and Methods
Between April 1992 and June 1995, 110 consecutive patients at our institution were randomized to undergo either LNF or conventional ONF, with 55 patients undergoing each procedure. The clinical details of the patients and the operative techniques have previously been described [2]. We have also previously reported subjective and objective outcomes of the two techniques in an 11-year follow-up of the patients. [16] The study was approved by the Turku University Hospital District ethics committee
Results
The objective endoscopic and clinical findings and subjective symptomatic outcomes in the study were in agreement with those in our previously reported 11-year investigation of outcome in the study population. There was a somewhat decreasing trend toward diminished dysphagia, in that only 42 patients (50.6%) in the 11-year follow-up reported the absence of dysphagia, whereas in the present 15-year follow-up 56 patients (67.5%) were asymptomatic for dysphagia (p = 0.0793). There was an
Comment
Laparoscopic Nissen fundoplication rapidly became the surgical procedure of choice in the operative treatment of GERD even before publication of the 1-year follow-up results of the first randomized trial comparing LNF and ONF [2]. This development occurred on the basis of early results that showed a lower morbidity with LNF than with ONF, accompanied by an equivalently high rate of patient satisfaction [20, 21, 22]. Besides our own comparative study of LNF and ONF, only one other randomized
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Refractory Gastroesophageal Reflux Disease: A Closer Look
2021, Physician Assistant ClinicsCitation Excerpt :One long-term randomized controlled prospective study of 86 patients compared laparoscopic versus open fundoplication outcomes over 15 years. At the 15-year follow-up, 76.7% of all patients were asymptomatic or only mildly symptomatic, whereas 10.5% reported difficult heartburn or regurgitation symptoms.19 In addition, 67.5% of patients overall denied having any dysphagia, whereas 3.5% reported “severe or difficult” dysphagia with improvement of dysphagia prevalence over time.19
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2019, Surgery (United States)Citation Excerpt :In contrast, we have observed that the patients who require the daily use of PPIs always correspond to reflux recurrence, contrary to what has been published before by other authors,45,46 who have suggested that only 30% of patients dependent on PPIs indeed had actual reflux. When analyzing the literature concerning the late results of LNF, we found 19 publications that reported this topic.10,12–29 A total of 10 (53%) used only symptomatic evaluations, endoscopic or functional studies were performed in a low number of patients in 6 (32%) of these reports, and only 11 (58%) discuss a follow-up in more than 80% of the patients.
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