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Laparoskopik Nissen Fundoplikasyonu: Tek Merkez Deneyimi

Laparoscopic Nissen Fundoplication: Single-Center Experience

Journal Name:

  • Fırat Tıp Dergisi

Publication Year:

  • 2012

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Objective: Our aim was examine the results of Laparoscopic Nissen Fundoplication operations performed for the treatment of gastroesophageal reflux disease within the last three years in our institution. Material and Methods: Twenty-seven patients who underwent Laparoscopic Nissen Fundoplication between June 2008 and March 2011 were retrospectively evaluated. There were 15 (%56) female and 12 (%44) male patients with a median age of 40 (range, 20-67 years). Prior to surgery all patients were given medical treatment for a period of at least two months. Endoscopy and esophageal biopsy was performed in all patients before surgery. Surgery was performed under general anesthesia using five ports. Esophagograms were obtained on postoperative first day for all patients. Results: All patients had complaints of heartburn and regurgitation. The median duration of symptoms before surgery was 12 months (range, 4 months-2 years). On preoperative endoscopic examination all of the patients had esophagitis and two of them had Barrett's esophagitis on histopathologic examination. All of the procedures were performed by laparoscopy and there was no conversion to open. Median operative time was 115 minutes (range, 75-170 minutes), and length of hospital stay was 3 days (range, 1-7 days). Median follow-up period was 13 months (7-40 months). One of the patients underwent reoperation for recurrent disease 10 months after the first operation. Functional results was excellent in 76%, good in 14%, and fair in 10% of the patients on follow-up. Conclusion: Laparoscopic Nissen Fundoplication is a safe and effective surgical procedure for the treatment of gastroesophageal reflux disease and it is an alternative treatment option to long-term drug therapy.
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Abstract (Original Language): 
Amaç: Gastroözofageal reflü hastalýðýnýn tedavisi için son üç yýlda uyguladýðýmýz Laparoskopik Nissen Fundoplikasyonu ameliyatlarýnýn sonuçlarýný deðerlendirmek. Gereç ve Yöntemler: Kliniðimizde Haziran 2008 ile Mart 2011 tarihleri arasýnda Laparoskopik Nissen Fundoplikasyonu uygulanan 27 hasta, geriye dönük olarak incelendi. Hastalardan 15'i kadýn (%56), 12'si erkekti (%44). Ortalama yaþ 40'tý (20-67). Hastalarýn tamamýna ameliyat öncesinde en az 2 ay süre ile medikal tedavi verildi. Tüm hastalara ameliyat öncesi endoskopi ve özofagus biyopsisi yapýldý. Ameliyatlar genel anestezi altýnda 5 port kullanýlarak yapýldý. Ameliyattan sonraki gün tüm hastalara özofagus pasaj grafisi çekildi. Bulgular: Hastalarýn tamamýnda göðüste yanma ve mide içeriðinin aðza geri gelmesi þikâyetleri mevcuttu. Þikâyetlerin baþlamasýndan ameliyata kadar geçen süre ortalama 12 aydý (4 ay-13 yýl). Ameliyat öncesi endoskopik incelemede bütün hastalarda özofajit tespit edildi. Histopatolojik incelemede, iki hastada Barrett özofajiti saptandý. Ameliyatlarýn hiç birinde açýða geçilmedi. Ortalama ameliyat süresi 115 dakika (75-170 dk), ortanca hastanede kalýþ süresi 3 gün (1-7 gün) idi. Ortanca takip süresi 13 ay olarak belirlendi (7-40 ay). Bir hasta ilk ameliyatýndan 10 ay sonra nüks hiyatus fýtýðý nedeniyle tekrar ameliyat edildi. Fonksiyonel sonuçlar hastalarýn %76'sýnda mükemmel, %14'ünde iyi, %10'unda orta olarak deðerlendirildi. Sonuç: Laparoskopik Nissen Fundoplikasyonu, gastroözofageal reflü hastalýðýnýn tedavisinde, düþük morbidite ve mortalite oraný ile uygulanabilecek ve uzun süreli ilaç tedavisine alternatif, cerrahi bir giriþimdir.
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  • 2
100-103
  • Turkish

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