Prospective randomized double-blind trial between laparoscopic Nissen fundoplication and anterior partial fundoplication.

摘要: Background: In the operative management of gastro-oesophageal reflux, a balance must be achieved between adequate control reflux and excessive dysphagia. The ideal technique is not known. A randomized study was performed to determine whether laparoscopic anterior fundoplication associated with lower incidence postoperative dysphagia than Nissen fundoplication, while achieving equivalent reflux. Methods: Patients presenting for antireflux surgery were undergo either (n = 53) or an 180° hemifundoplication 54). Patients blinded which procedure had been performed, follow-up obtained by independent investigator. Standardized clinical grading systems used assess dysphagia, heartburn patient satisfaction 1, 3 6 months after operation. Objective measurement oesophageal sphincter pressure, emptying time, distal acid exposure endoscopic healing oesophagitis also performed. Results: Operating time similar two procedures (58 min versus 60 fundoplication). Resting residual pressures following (29 18 mmHg, 13 mmHg), times faster (92 116 s). Acid ability heal similar. At months' outcomes procedures. months, however, patients who undergone experienced significantly less solid food more likely satisfied outcome. Conclusion: Laparoscopic physiological manometry parameters, improved outcome at months. Continued remains necessary confirm long-term efficacy partial procedure. © 1999 British Journal Surgery Society Ltd