Long-term results of antireflux surgery indicate the need for a randomized clinical trial

Br J Surg. 2002 Feb;89(2):225-30. doi: 10.1046/j.0007-1323.2001.01990.x.


Background: Well conducted, comparative trials of laparoscopic versus open antireflux surgery with an adequate patient enrollment are few and they do not demonstrate obvious advantages for the laparoscopic approach except for a marginal gain in shorter hospital stay. The aim of this study was to compare the effectiveness of laparoscopic and open procedures.

Methods: Two unselected groups of 230 patients were identified through a register of all inpatient public care in Sweden. Outcomes of laparoscopic and open antireflux surgery were compared using a disease-specific questionnaire 4 years after operation.

Results: Failure and dissatisfaction were significantly more common in the laparoscopy group than among patients having conventional open surgery. Treatment failure rates were 29.0 and 14.6 per cent respectively (P = 0.004). Dissatisfaction rates were 15.0 and 7.0 per cent respectively (P = 0.005). There was no other questionnaire item for which the proportion of failures differed significantly between the two groups.

Conclusion: This study does not support the presumption that laparoscopic antireflux surgery is to be preferred to the open procedure. It is strongly recommended that a randomized controlled trial be conducted.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Body Mass Index
  • Cicatrix
  • Deglutition Disorders / etiology
  • Female
  • Flatulence / etiology
  • Gases
  • Gastroesophageal Reflux / epidemiology
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods
  • Laparoscopy / standards*
  • Laparotomy / adverse effects
  • Laparotomy / methods
  • Laparotomy / standards*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Randomized Controlled Trials as Topic
  • Sex Factors
  • Surveys and Questionnaires
  • Sweden / epidemiology
  • Treatment Outcome


  • Gases