Indications for the Laparoscopic Treatment of Gastroesophageal Reflux Disease

BACKGROUND The aim of the study was to evaluate the indications and surgical techniques for the treatment of gastroesophageal reflux disease. METHODS From 1998 through 2000, we performed gastroesophageal reflux surgery on 12 patients. Preoperative studies revealed third-degree esophagitis in most patients with no functional alterations of the esophagus itself. The patients underwent a laparoscopic Nissen-Rossetti fundoplication. No conversions to open laparotomy were necessary. The mean operative time was 180 minutes. RESULTS No intraoperative or immediate postoperative complications occurred. The mean postoperative stay was 6.2 days. Transitory postoperative dysphagia was noted in 8 patients. In 5 patients, it was mild and regressed after 2 weeks; in 3 cases, it was severe and regressed over 2 months. CONCLUSION A laparoscopic surgical approach is a satisfactory method for correcting gastroesophageal reflux disease. The efficacy of medical therapy has been well established. However, in the young person who may be required to take medication for many years or in those persons who are intolerant of standard medical therapy for gastroesophageal reflux disease, a surgical intervention is a satisfactory option. The success of medical therapy can be used as a predictive criterion of the success of laparoscopic Nissen-Rosetti fundoplication when normal motility of the esophageal corpus is present.