Five-year comprehensive outcomes evaluation in 181 patients after laparoscopic Nissen fundoplication

J Am Coll Surg. 2003 Jan;196(1):51-7; discussion 57-8; author reply 58-9. doi: 10.1016/s1072-7515(02)01604-6.


Background: We conducted an objective followup of 181 patients after laparoscopic Nissen fundoplication during a 5-year period after surgery.

Study design: Patients underwent 24-hour pH recording, esophageal manometry, and symptom score assessment for six gastroesophageal reflux disease symptoms preoperatively and at 6 months, 2 years, and 5 years after surgery.

Results: Laparoscopic fundoplication was associated with a significant (p < 0.0001) increase in lower esophageal sphincter pressure and a significant (p < 0.0001) drop in duration of acid reflux in 24 hours, and symptom score, 6, 24, and 60 months after surgery when compared with preoperative values. Twenty-one patients (12%) have experienced recurrence of reflux-type symptoms, but only six have required repeat surgery. Lower esophageal sphincter tone dropped between 6 months and 5 years after surgery, but was still an effective antireflux barrier. Patient satisfaction with surgery dropped over the 5-year followup but remained high, at 86%, after 5 years.

Conclusions: Laparoscopic Nissen fundoplication remains an effective antireflux procedure at 5 years.

MeSH terms

  • Adult
  • Diagnostic Techniques, Digestive System
  • Female
  • Follow-Up Studies
  • Fundoplication / methods*
  • Gastroesophageal Reflux / diagnosis
  • Gastroesophageal Reflux / physiopathology
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Intraoperative Complications
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Postoperative Complications
  • Recurrence
  • Reoperation
  • Time Factors
  • Treatment Outcome