Laparoskopisk fundoplikasjon for gastroøsofageal reflukssykdom

BACKGROUND: In 1995 we introduced laparoscopic technique as routine for fundoplication for gastro-esophageal reflux disease. MATERIAL AND METHODS: 222 patients were scheduled for laparoscopic fundoplication; the operation was completed laparoscopically in 219 patients. They all had an observation period of one year as a minimum; 205 patients returned a follow-up questionnaire. RESULTS: 12 patients had major complications, six of them have been reoperated. At follow-up, 95% reported excellent or good results, 3% had persisting reflux symptoms, 4% had moderate to severe dysphagia and 17% had moderate to severe gas bloat syndrome and flatulence problems which adversely affected an otherwise good outcome. Thus, 63% reported excellent, 23% good and 7% fair outcome, and 6% were moderately or very dissatisfied. Bloating and increased flatulence were the major reasons for dissatisfaction. INTERPRETATION: The risk of troublesome postoperative bloating and flatulence should be addressed thoroughly during the preoperative information, and especially in patients who have similar symptoms preoperatively.