This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Ten‐year results of a randomized clinical trial of laparoscopic total fundoplication with or without division of the short gastric vessels. BJS 2009; 96: 61-65.
Published: 17th November 2008
Authors: J. Mardani, L. Lundell, H. Lönroth, J. Dalenbäck, C. Engström
Background
Total fundoplication is the most common antireflux operation and can be performed with or without division of the short gastric vessels. There seems to be no difference in short‐term outcomes with either approach. The aim of the study was to determine whether there were the long‐term differences (after 10 years).
Method
Ninety‐nine patients were enrolled in the study. Short gastric vessels were divided in 52 patients (group 1) and left intact in 47 (group 2). Ten patients were lost to follow‐up and seven patients died, leaving 42 patients for analysis in group 1 and 40 in group 2. All patients were evaluated by standardized quality of life questionnaires.
Results
Three patients underwent reoperation within 5 years. Thirty‐eight of 42 patients with a completely mobilized fundus reported no reflux symptoms, compared with 31 of 40 patients with intact vessels. There were no differences between the groups in other symptoms reflecting postfundoplication complaints and quality of life outcomes.
Conclusion
When total fundoplication is performed it makes no difference whether the fundus is mobilized or not. Both types of repair provide lasting control of reflux. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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