Abstract

SILVA, Guedes da et al. A fundoplicatura total por laparoscopia na doença do refluxo gastresofágico. J Port Gastrenterol. [online]. 2006, vol.13, n.1, pp.14-21. ISSN 0872-8178.

Sixty-two patients with GERD, with or without hiatal hernia, underwent total laparoscopic Nissen fundoplication (between Septiber 1995 and October 2003) on our surgery service (Serviço 6, Hospital Santo António dos Capuchos, Lisboa, Portugal) with no subsequent mortality. Of these, 55 patients (89%) were treated by laparoscopy alone. The riaining 7 patients (11%) were excluded from this analysis due to conversion to laparotomy. Selection for surgical treatment was based on the patient's history and upper endoscopy, 24-hour intra-oesophageal pH and manometry results. A uniform operative technique was used for the fundoplication, with only slight differences relating to progression or differences in circumstances. Average post-operative stay was 4.2 days. Outpatient follow-up included 50 patients. After an average follow-up of 17.6 months, 98% of patients were asymptomatic. Additional post-operative tests were carried out in fifteen volunteers to evaluate the efficacy of fundoplication in the control of GERD and hiatal hernia. Application of the Wilcoxon's test (p=0.0001) supported the efficacy of the method.

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