Long-Term Outcomes of Laparoscopic Nissen Fundoplication

Clinical Takeaway

: Nissen fundoplication provides durable GERD relief, although gas bloating and dysphagia are common, and one quarter of patients resume PPIs.

Context

Short-term outcomes of laparoscopic Nissen fundoplication (LNF) for gastroesophageal reflex disease (GERD) are well established, but data on outcomes beyond 10 years are limited. A new meta-analysis of 12 observational studies (1300 patients; mean follow-up, 13 years) provides the most comprehensive long-term picture to date. No study included a medically managed control group.

Key Results

After LNF, significantly fewer patients reported heartburn (94% before and 34% after) and regurgitation (69% before and 13% after); endoscopic evidence of esophagitis was less common (62% before and 7% after). However, 24% of participants were using proton-pump inhibitors (PPIs) by the end of follow-up.
Surgery-related symptoms were common and include…

Reviewing Authors

Sharmeel Kaur Wasan, M.D.

Guest Author

Dr. Wasan is the Gastroenterology Fellowship Program Director at Boston Medical Center in Massachusetts.