부산대학교 도서관

Gastro-oesophageal reflux disease (GERD) is, now, common in Indians. Anti-reflux surgery is gaining popularity as its definitive treatment option. However, studies from India on anti-reflux surgery are scarce. This study audits a low volume centre's experience with laparoscopic Nissen's fundoplication (LNF) in the management of GERD. Patients undergoing LNF between June 2014 and September 2019 were studied. Subjective and objective assessments of GERD were made using validated symptom indices and endoscopy, respectively, during both pre-operative evaluation and post-operative follow-up, to assess outcomes. Twenty-four-hour pH monitoring was selectively used in equivocal cases. Short and floppy LNF was constructed without using oesophageal bougie. Fifty-nine patients (39 males:20 females) with a mean age of 52.5 ± 16.2 years underwent LNF. The severity of typical symptoms improved significantly (p < 0.05) within 15 days following surgery. Clinical improvement, in the severity of atypical symptoms too, was observed but was not found statistically significant. There were no major perioperative complications or mortality. Three patients needed endoscopic dilatation at 3 months for persistent dysphagia. No failures or recurrences were observed during the follow-up. Structured subjective and objective assessment by the operating team has revealed that LNF proves efficacious in the management of GERD even in a low volume centre.
Author(s): Tarun Peela [sup.1], Jayant Kumar Banerjee [sup.2], Sita Ram Ghosh [sup.3], Shrirang Vasant Kulkarni [sup.4], V. R. Mujeeb [sup.5], Ramanathan Saranga Bharathi [sup.6] Author Affiliations: (1) Divisional Railway Hospital, [...]