What is the long-term efficacy of laparoscopic nissen fundoplication?

What is the long-term efficacy of laparoscopic nissen fundoplication?

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ABSTRACT The treatment of GERD usually entails either PPIs or surgery. It has been reported that 62% of patients who have undergone laparoscopic Nissen fundoplication used PPIs at long-term follow-up, and this finding has raised concerns about the durability of such surgery. In this Practice Point commentary, I discuss the findings and limitations of a study by Oelschlager _ et al_., which reported the long-term (≥66 months) follow-up data of 228 of 441 patients who underwent laparoscopic fundoplication at their institution. Control of heartburn and regurgitation was achieved in more than 90% of patients, with a low rate of adverse effects and subsequent repeat surgery, and an excellent overall outcome. PPIs were used by 23% of patients at long-term follow-up, similar to most other reports. However, 35% of the original cohort was lost to follow-up. It has been reported elsewhere that the apparent outcome for antireflux surgery is influenced by the completeness of follow-up, but other reports of 10-year outcomes with near-complete follow-up describe similar success. Oelschlager _ et al_.'s data, and other reports, show that a good long-term outcome is achieved in ∼90% of patients who undergo laparoscopic Nissen fundoplication for GERD. Access through your institution Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and online access $209.00 per year only $17.42 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Spechler SJ _ et al_. (2001) Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease: follow-up of a randomized controlled trial. _JAMA_ 285: 2331–2338 Article  CAS  Google Scholar  * Oelschlager BK _ et al_. (2008)Long-term outcomes after laparoscopic antireflux surgery. _Am J Gastroenterol_ 103: 280–288 Article  Google Scholar  * Kelly JJ _ et al_. (2007) Nissen fundoplication: clinical outcomes at 10 years. _J Am Coll Surg_ 205: 570–575 Article  Google Scholar  * Ludemann R _ et al_. (2003) Influence of follow-up methodology and completeness on apparent clinical outcome of fundoplication. _Am J Surg_ 186: 143–147 Article  Google Scholar  * Morgenthal CB _ et al_. (2007) The durability of laparoscopic Nissen fundoplication: 11-year outcomes. _J Gastrointest Surg_ 11: 693–700 Article  Google Scholar  Download references AUTHOR INFORMATION Author notes * Room 3D211, Flinders Medical Centre, Bedford Park, SA 5042, Australia david.watson@flinders.edu.au AUTHORS AND AFFILIATIONS * DI Watson is Professor of Surgery and Head of the Flinders University Department of Surgery, Flinders Medical Centre, Bedford Park, SA, Australia., David I Watson Authors * David I Watson View author publications You can also search for this author inPubMed Google Scholar ETHICS DECLARATIONS COMPETING INTERESTS The author declares no competing financial interests. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Watson, D. What is the long-term efficacy of laparoscopic Nissen fundoplication?. _Nat Rev Gastroenterol Hepatol_ 5, 540–541 (2008). https://doi.org/10.1038/ncpgasthep1227 Download citation * Received: 03 June 2008 * Accepted: 04 July 2008 * Published: 19 August 2008 * Issue Date: October 2008 * DOI: https://doi.org/10.1038/ncpgasthep1227 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative

ABSTRACT The treatment of GERD usually entails either PPIs or surgery. It has been reported that 62% of patients who have undergone laparoscopic Nissen fundoplication used PPIs at long-term


follow-up, and this finding has raised concerns about the durability of such surgery. In this Practice Point commentary, I discuss the findings and limitations of a study by Oelschlager _ et


al_., which reported the long-term (≥66 months) follow-up data of 228 of 441 patients who underwent laparoscopic fundoplication at their institution. Control of heartburn and regurgitation


was achieved in more than 90% of patients, with a low rate of adverse effects and subsequent repeat surgery, and an excellent overall outcome. PPIs were used by 23% of patients at long-term


follow-up, similar to most other reports. However, 35% of the original cohort was lost to follow-up. It has been reported elsewhere that the apparent outcome for antireflux surgery is


influenced by the completeness of follow-up, but other reports of 10-year outcomes with near-complete follow-up describe similar success. Oelschlager _ et al_.'s data, and other


reports, show that a good long-term outcome is achieved in ∼90% of patients who undergo laparoscopic Nissen fundoplication for GERD. Access through your institution Buy or subscribe This is


a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and online access $209.00 per


year only $17.42 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated


during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Spechler SJ _ et al_. (2001) Long-term


outcome of medical and surgical therapies for gastroesophageal reflux disease: follow-up of a randomized controlled trial. _JAMA_ 285: 2331–2338 Article  CAS  Google Scholar  * Oelschlager


BK _ et al_. (2008)Long-term outcomes after laparoscopic antireflux surgery. _Am J Gastroenterol_ 103: 280–288 Article  Google Scholar  * Kelly JJ _ et al_. (2007) Nissen fundoplication:


clinical outcomes at 10 years. _J Am Coll Surg_ 205: 570–575 Article  Google Scholar  * Ludemann R _ et al_. (2003) Influence of follow-up methodology and completeness on apparent clinical


outcome of fundoplication. _Am J Surg_ 186: 143–147 Article  Google Scholar  * Morgenthal CB _ et al_. (2007) The durability of laparoscopic Nissen fundoplication: 11-year outcomes. _J


Gastrointest Surg_ 11: 693–700 Article  Google Scholar  Download references AUTHOR INFORMATION Author notes * Room 3D211, Flinders Medical Centre, Bedford Park, SA 5042, Australia


[email protected] AUTHORS AND AFFILIATIONS * DI Watson is Professor of Surgery and Head of the Flinders University Department of Surgery, Flinders Medical Centre, Bedford Park,


SA, Australia., David I Watson Authors * David I Watson View author publications You can also search for this author inPubMed Google Scholar ETHICS DECLARATIONS COMPETING INTERESTS The


author declares no competing financial interests. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Watson, D. What is the long-term efficacy of


laparoscopic Nissen fundoplication?. _Nat Rev Gastroenterol Hepatol_ 5, 540–541 (2008). https://doi.org/10.1038/ncpgasthep1227 Download citation * Received: 03 June 2008 * Accepted: 04 July


2008 * Published: 19 August 2008 * Issue Date: October 2008 * DOI: https://doi.org/10.1038/ncpgasthep1227 SHARE THIS ARTICLE Anyone you share the following link with will be able to read


this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative