Laparoscopic antireflux surgery for gastroesophageal reflux disease: report on a 4-year experience

In a period of 4 years between March 1994 and March 1998, 143 patients with gastroesophageal reflux disease (GERD) underwent laparoscopic antireflux surgery. According to manometric studies 76 patients had a short-floppy Nissen fundoplication, patients with impaired motility or paraesophageal hernias received a hemifundoplication (Toupet = 42, Dor/Thal = 25). Recurrent reflux symptoms appeared in 6.3% after mean 16.7 months follow-up (Nissen = 2.6%, Toupet = 2.3%, Dor/Thal = 24%, P < 0.01). Persistent dysphagia with reoperation occurred in 2.1% (Nissen = 2.6%, Toupet = 2.3%, Dor/Thal = 0%, n.s.). The assessment of Visick's score at the latest control showed the following: Visick I = 63.6%, Visick II = 30.1%, Visick III = 6.3%, Visick IV = 0%. The outcome of the operation was rated "excellent" or "good" by 91.6% of the patients.