Laparoscopic anti-reflux surgery in gastroesophageal reflux. Diagnosis, surgical technique and outcome in 143 patients

Within the period March 1994 to March 1998, 143 patients with gastroesophageal reflux disease (GERD) underwent laparoscopic antireflux surgery. According to manometric studies, 76 patients underwent short-floppy laparoscopic Nissen fundoplication, 42 patients with impaired motility had a Toupet hemifundoplication, and 25 patients had an anterior Dor hemifundoplication. Recurrent reflux symptoms appeared in 6.3% after 16.7 +/- 12 months of follow-up (Nissen 2.6%, Toupet 2.3%, Dor 24%, p < 0.01). Persistent dysphagia with reoperation occurred in 2.1% (Nissen 2.6%, Toupet 2.3%, Dor = 0%, n.s.). Follow-up included assessment of the Visick score and patient satisfaction with operation results. Excellent or good results were found in 92% of the patients.