Clinical Outcomes and Quality of Life after Laparoscopic Nissen Fundoplication for Refractory Gastroesophageal Reflux Disease: A Prospective Cohort Study from Vietnam

Background/Aims: Gastroesophageal reflux disease (GERD) significantly impairs quality of life. Although proton pump inhibitors are first-line therapy, a subset of patients remains refractory to medical treatment. Laparoscopic Nissen fundoplication (LNF) is considered the gold-standard surgical option; however, high-quality prospective outcome data from Southeast Asia, particularly Vietnam, remain limited. This study aimed to evaluate clinical outcomes and symptom control following LNF in patients with refractory GERD. Methods: This prospective cohort study included 61 consecutive patients with refractory GERD who underwent LNF at Can Tho General Hospital between March 2022 and September 2025. Gastroesophageal reflux disease questionnaire (GERD-Q) scores and symptom control were assessed at 1 month, 6 months, 12 months, and at the end of follow-up. Results: The mean age was 38.9±14.3 years, and 54.1% of patients were male. All procedures were completed laparoscopically, with a mean operative time of 102.3±17.4 minutes. Postoperative recovery was rapid, with early resumption of oral intake and ambulation. Postoperative complications occurred in 19.7% of patients and were limited to Clavien-Dindo grades I-II, with no mortality. GERD-Q scores decreased significantly from 14.26±1.69 preoperatively to 7.00±0.99 at 1 month and continued to decline during follow-up, reaching 5.41±1.18 at the end of the study (p<0.001). Good symptom control was maintained in 83.6-90.2% of patients across follow-up time points. Conclusions: LNF is a safe and effective treatment for refractory GERD, providing rapid recovery and durable symptom control in appropriately selected patients.