Laparoscopic Nissen Fundoplication; Long Term Clinical Study

Background: Gastroesophageal reflux disease (GERD) is one of the most common benign medical conditions of stomach and esophagus.Aim: To review the cases of laparoscopic Nissen fundoplication carried out at our hospital and to analyze the prognostic factors that influenced surgical outcome.Patients and methods: This was a retrospective study of the patients who underwent laparoscopic Nissen fundoplication in the period between January 2017 till December 2021 at Gastrointestinal Surgical Center, Mansoura University, Egypt.Results: 70.9% of patients have no intraoperative difficulties, while 18.8% have large hiatus hernia, 5.5% adhesions, 2.4% gastric volvulus, 1.8% large left lobe. Intra-operative complications were found to be minimal, with 95.8% having no complications. The mean hospital stay ranged from 1 to 4 days, with one case causing vomiting. 56.6% of cases did not use PPI, while 22% used it, and 21.4% used it intermittently. 16 cases needed redo surgery, with 18.8% due to dysphagia and 81.2% due to disrupted and migrated wrap. The mean GERD quality of life score was 9.86±11.37.Conclusion: Nissen fundoplication may be a better option for GERD patients, minimizing symptoms like dysphagia, heartburn, and regurgitation, with no post-operative complications and a positive correlation between patient satisfaction.