Year 2005 / Volume 97 / Number 5
Original
Surgery for gastroesophageal reflux disease: a comparative study between the open and laparoscopic approaches

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R. Trullenque Juan, T. Torres Sánchez, E. Martí Martínez, M. Martínez Abad, R. Trullenque Peris and F. Delgado Gomis

Abstract
Objective: given the demonstrated effectiveness of medical treatment together with the eminent acceptance of the laparoscopic approach, the indications of surgery in the treatment of
gastroesophageal reflux disease (GERD) are currently subject to continuous controversy. To participate in this debate, we have the following work hypothesis: “The results of the 360º short and
floppy laparoscopic fundoplication are superior to those of open surgery”.
Clinical design: prospective, clinical, non-randomized study.

Patients: our work was developed between November 1991 and December 1998 by means of a prospective, non-randomized clinical rehearsal with two groups of patients:
—Group I (n = 75): 360° short and floppy laparoscopic fundoplication in Hospital Dr. Peset, Valencia (Spain).
—Group II (n = 28): 360° short and floppy, open fundoplication in Hospital General, Valencia (Spain).
We evaluated the preoperative parameters and found no differences, which allows us to know that both groups were comparable.

Results: the analysis of peroperative results (morbidity and surgical time) and of clinical follow-up (every three months and later annually) and instrumental follow-up (TEGD, upper digestive
endoscopy, pHmetry and manometry) show no differences, while the postoperative analysis shows statistically significant (s.s.) differences regarding recovery (pain, oral intake, hospital stay and return
to previous activities).

Conclusions: the results of the 360° short and floppy laparoscopic undoplication are similar to those of the open approach, but favor the former approach with a better postoperative tolerance
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R. Trullenque Juan, T. Torres Sánchez, E. Martí Martínez, M. Martínez Abad, R. Trullenque Peris and F. Delgado Gomis. Surgery for gastroesophageal reflux disease: a comparative study between the open and laparoscopic approaches. 0


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