These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: [Follow-up results and learning curve in laparoscopic gastrofundoplications].
    Author: Endzinas Z, Maleckas A, Mickevicius A, Kiudelis M.
    Journal: Zentralbl Chir; 2002 Nov; 127(11):939-43. PubMed ID: 12476365.
    Abstract:
    AIM OF THE STUDY: To analyze the postoperative results and the learning curve of laparoscopic gastrofundoplications by postoperative clinical monitoring of consequences and self-evaluation of complaints 12 months after surgery. METHODS: One hundred patients (58 female and 42 male) were operated at the Department of Surgery, Hospital of Kaunas University of Medicine, from April 1998 to January 2001 because of hiatal hernias, complicated with gastroesophageal reflux (in 59 cases sliding axial non-fixed, in 38 cases sliding axial fixed, and in 3 cases paraesophageal hernias were found). 89 Nissen and 11 Toupet fundoplications were performed. Patients were distributed into five groups (20 patients in each). Operation time, number of postoperative complications, postoperative hospital stay were analyzed. RESULTS: The mean operation time was 198 min in the 1 st group, 105 min in the 2 nd group, 110 min in the 3 rd group, 124 min in the 4 th group and 120 min in the 5 th group. Conversion to laparotomy was necessary in two cases (the 1 st and the 2 nd groups). The number of postoperative complications decreased from 5 in the 1 st group to 2 in the 2 nd group, and to 1 in the 3 rd and 4 th groups; no complications were noted in the 5 th group. According patient's opinion, successful results were received in 87 %. CONCLUSIONS: Laparoscopy is a good approach for surgical management of hiatal hernias complicated with gastroesophageal reflux, but laparoscopic gastrofundoplication needs advanced skills to be performed safely. The learning curve in terms of operation time covered initial 20 procedures and remained stable afterwards, the number of postoperative complications decreased after initial 20 operations, but dangerous complications occurred until the 60 th procedure. Other conventional elective surgical procedures of medium extent can be successfully performed simultaneously with laparoscopic fundoplication without affecting the outcome. The true learning curve of laparoscopic fundoplication can be drawn by careful follow-up and analysis of long-term postoperative results; this enables to improve operative techniques.
    [Abstract] [Full Text] [Related] [New Search]