SHORT–TERM FOLLOW UP OF DIFFERENT SURGICAL PROCEDURES USED IN MANAGEMENT OF GASTROESOPHAGEAL REFLUX DISEASE

ABSTRACTIntroduction : This study was designed to assess the short term follow up of different surgical procedures either performed laproscopically or through open surgery used in treatment of gastroesophageal reflux disease. Patients and methods : Twenty patients having long history of symptoms reflux esophagitis proved by preoperative upper gastrointestinal endoscopy, esophageal manometry and 24 hour pH monitoring of the esophagus. Theses patients managed with medical treatment (proton pump inhibitor, prokinetics) therapy for 12 months before admission. All patients were subjected to complete history, physical examination, routine preoperative laboratory investigation, abdominal ultrasound, upper gastro-intestinal endoscopy, esophageal manometry and 24 hours pH monitoring. Results : This study showed no operative complications, didn’t include any mortality. In cases operated laparoscopic fundoplication there was no conversion to open surgery. The important postoperative problem were dysphagia and gas bloatsyndrom, recurrence symptomes like heartburn and regurgitation. 90% of the patients were satisfied with the outcome of the performed procedure. 70% of studied cases operated laparoscopic fundoplication either complete or partial wrap with satisfied results comparing to other recent researches. Antireflux surgery is superior over medical treatment regarding control of reflux symptoms and prevention of complications. Conclusion : Fundoplication is the most common antireflux procedure world wide with accepted results. With availability of experienced laparoscopic surgeon and will trained team, with no other indication of open surgery, laparoscopic procedures superior to open surgery regarding return to oral diet, hospital stay, need for postoperative analgesia and less respiratory complications.