New England Surgical Society (NESS)
Search NESS
  Home
  Annual Meeting
  Annual Resident and Fellow Research Day
  Members
      Member Directory
      Members Only
  Scholars Foundation
  Job Board
  Awards
  Journal of the American College of Surgeons
  Newsletters
  Committees
  Contact NESS

Back to NESS Scientific Program


Measuring the Effectiveness of Laparoscopic Nissen Fundoplication: Long Term Results
Denise W Gee, Michael T Andreoli, David W Rattner
Massachusetts General Hospital, Boston, MA

OBJECTIVE: To evaluate the long-term results and quality of life of patients undergoing laparoscopic Nissen fundoplication (LNF).
DESIGN: A validated survey instrument, the Gastroesophageal Reflux Disease--Health-Related Quality-of-Life scale (GERD-HRQL) was mailed to all patients who underwent LNF from 1997-2006. Additional information was obtained regarding re-intervention, satisfaction, and medication use.
SETTING: Tertiary care referral center.
PATIENTS: 412 consecutive patients who underwent either primary LNF or laparoscopic re-do fundoplications (re-do LNF) by a single surgeon from 1997-2006.
MAIN OUTCOME MEASURES: GERD-HRQL score, re-operation rate, antisecretory medication usage.
RESULTS: A 46% response rate (188/412) was obtained. Median follow-up was 60 months (range 4-75 months). Mean GERD-HRQL score was 5.25 +/- 7.67 (scale range 0-45 with 0 representing no symptoms). 72% of patients were “satisfied” with the long-term result of surgery. 87% of patients stated they would have the surgery again. 44% of patients took antireflux medications at some point following surgery. Half of those on medication had no diagnostic testing to document the recurrence of GERD. Only three patients (2%) undergoing primary LNF required re-operation. Patients undergoing re-do LNF had higher GERD-HRQL scores (mean 13.6 +/- 10.8), lower satisfaction (43%) and greater probability of requiring antisecretory medication (71%).
CONCLUSIONS: This is the largest reported series of LNF from New England with long-term follow up. Contrary to reports in the medical literature, our results demonstrate that patients undergoing primary LNF by an experienced surgical team have near normal GERD-HRQL scores at long-term follow up, low re-operation rates, and are satisfied with their decision to undergo surgery. The results following re-do LNF are not as good, highlighting the importance of patient selection and proper surgical technique when performing primary LNF.


Back to NESS Scientific Program

Copyright © 2018 New England Surgical Society. All Rights Reserved.
Read Privacy Policy.