Laparoscopic hiatoplasty and fundoplication: retrospective
analysis in 2000–2003
Marko Ľ.1, Molnár P.1, Marková I.2, Koreň R.1
1Oddelenie miniinvazívnej chirurgie a endoskopie, FNsP FD Roosevelta, Banská Bystrica, primár MUDr. Ľubomír Marko 2Rádiodiagnostické oddelenie, FNsP FD Roosevelta, Banská Bystrica, primár MUDr. Stanislav Okapec |
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Summary:
Gastroesophageal reflux dissease is very frequent diagnosis
with increased trend in present population. In
patients population where conservative tretment failed is
indicated surgical therapy. The gold standard represents
laparoscopic fundoplication with hiatoplasty. In our
department more than 320 laparoscopic hiatoplasties
and fundoplications in patients with clinically proven
signs of the gastroesophageal reflux (GER) and with or
without presence of hiatal hernia were performed. There
were 2 times (0,62%) conversions to open operation,
1 times (0,3%) urgent reoperation for acute bleeding and
7 times (2,2%) reoperation for rupture of hiatoplasty or
fundoplication valve. The authors present retrospective
analysis of the operations made within 2000–2003, when
operating surgeon (LM) made 140 operations for above
mentioned diagnosis. All patients were reviewed using
questionnaire. 70% patients sent back the fullfilled questionnaire
(98 from 140 patients). Before operation all
patients had heartburn within 0,5–45 years (range
10–11 years), the diagnosis was made within 6 months
till 20 years before operation (range 4 years). All patients
were examined by endoscopy 1–50 times (range 8
time before surgery), medical therapy was used before
operation within 6 months till 40 years (range 4–5
years), 43 times was diagnosed inflammatory disease of
the esophagus by endoscopy. Radiodiagnostic examinations
were made in 52 cases, pH-metry 10 times, manometry
4 times. After operation dysphagia was present
within some weeks to 1 year (25% of patients within
1 month), 4 patients have mild degree od permanent dysphagy.
After operation 61 patients (62,2%) consider quality
of the life themselves as a perfect one, 29 patients
(29,6%) are satisfied with (sometimes) minimal signs of
heartburn and 8 patients (8,2% of all) are not satisfied
from various reasons.
Key words:
gastroesophageal reflux, hiatal hernia, laparoscopic
fundoplication, postoperative quality of life
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