Symptomatic outcome following laparoscopic anterior 180 partial fundoplication: Our initial experience

摘要

Gastroesophageal reflux disease is increasing in frequency in the Asia Pacific region, which can be attributed to increase in awareness among doctors and patients and/or true increase in the prevalence of this disease. Surgical treatment of GERD is well established in the West and in selected clinical situations, provides well recognized benefits over non-surgical treatment. In contrast, there are only a few published studies in Asia especially on the outcome of the laparoscopic anterior fundoplication within the Asian community. Our aim is to evaluate symptomatic outcome of laparoscopic anterior 180° fundoplication in our community. Prospective analyses of 25 consecutive patients were done using a standardized questionnaire post-operatively. Overall satisfaction and the symptoms of heartburn and dysphagia were assessed together with other adverse effects of the surgery. Follow up was carried at a median of 9 months after surgery. Symptoms of heartburn assessed using the VAS showed significant drop from mean 7.4 pre-operatively to mean 1.75 postoperatively. De Meester symptom score indicated that a majority (56%) of patients reported none/minimal GERD symptoms, the other 44% reported mild GERD symptoms. This showed a vast improvement compared to pre-operative scoring where 80% of the patients reported moderate to severe GERD symptoms. This directly correlates with the estimation of patient satisfaction using Visick grading system with 24 (96%) patients reported none or mild symptoms post operatively. Overall, it is reasonable to conclude that laparoscopic anterior partial fundoplication achieved a satisfactory rate of overall success in our centre at short term follow up.