2008, Number 4
Comparison between Nissen-type fundoplication and fundoplication in “V” for the treatment of gastroesophageal reflux (GER). Results from two laparoscopic techniques
Velázquez MJD, Munguía CDA, González GR, Saldaña TF, Vega MAJ
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Language: Spanish
References: 0
Page: 184-190
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ABSTRACT
Objective: To compare the results from two anti-reflux techniques through laparoscopy, and to determine if fundoplication in “V” has less dysphagia incidence in the immediate and the late post-operative period than Nissen-type fundoplication. Site: PEMEX Regional Hospital, Salamanca, Guanajuato State, México. Design: Observational, prospective, longitudinal, and comparative study. Statistical Analysis: Student’s “t” distribution, Chi-square distribution test, Fisher’s exact test. Material and methods: This study was carried out at the PEMEX Regional Hospital, Salamanca, Guanajuato State, Mexico, during the period going to January 2006 to June 2007. Every patient having been diagnosed esophageal reflux was included in the study. The patients had an indication for laparoscopic fundoplication and they accepted the anti-reflux procedure. The analyzed variables were age, gender, used technique, operation time, conversion to open surgery, length of post-operative hospital stay, and Visick grading scale. Results: Forty-five anti-reflux procedures were performed through laparoscopic route. The treated patients were 23 men and 22 women; the average age was of 43 years old, ranging from 31 to 71 years old. The patients were practiced a fundoplication in “V”. Five patients from the A group presented dysphagia, and just one patient from the B group presented this mentioned problem. The patients who presented Nissen-type post-fundoplication dysphagia were three men and two women. In the fundoplication in “V” group, dysphagia was present in one woman. When comparing the groups, no significant difference was found, p › 0.05. The grade of dysphagia was slight in every case and it ceased after less than a month when treated by general and dietetic measures. Conclusion: The two assessed techniques present similar post-operative dysphagia probabilities and both techniques have a proper satisfaction grade in the reflux control.