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  • Title: Laparoscopic Nissen fundoplication for gastroesophageal reflux disease in Japan.
    Author: Takeyama S, Numata A, Nenohi M, Shibata Y, Okushiba S, Katoh H.
    Journal: Surg Today; 2004; 34(6):506-9. PubMed ID: 15170546.
    Abstract:
    PURPOSE: Laparoscopic antireflux surgery is the standard treatment for gastroesophageal reflux disease (GERD) in Western countries where this disorder is common; however, it has only recently been introduced in Japan. We examined the effectiveness of laparoscopic antireflux surgery in a small series of Japanese patients. METHODS: Between 1998 and 2001 we performed laparoscopic Nissen fundoplication in 23 patients to evaluate the efficiency of this technique. We examined the following four parameters pre- and postoperatively: symptoms, endoscopic findings, gastroesophagogram findings, and the results of intraesophageal 24-h pH monitoring. We also examined the operation time, blood loss, intraoperative complications, and postoperative complications. RESULTS: The operation was safely performed in all patients, regardless of age, and there were no intraoperative complications. Postoperatively, more than three parameters were effectively normalized in 17 (89.5%) of 19 patients. The only postoperative complications were delayed gastric emptying in three patients and persistent dysphagia in five patients. During follow-up, esophagitis recurred in two patients, one of whom underwent laparoscopic refundoplication, which normalized the condition. CONCLUSION: Laparoscopic Nissen fundoplication is highly effective for GERD and could become the standard surgical treatment in Japan.
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