Long-term symptomatic follow-up after Lind fundoplication
Article first published online: 6 DEC 2002
© 2000 British Journal of Surgery Society Ltd
British Journal of Surgery
Volume 87, Issue 3, page 370, March 2000
How to Cite
Cameron, I. C., Stoddard, J. E., Treacy, P. J., Patterson, J. and Stoddard, C. J. (2000), Long-term symptomatic follow-up after Lind fundoplication. Br J Surg, 87: 370. doi: 10.1046/j.1365-2168.2000.01383-23.x
- Issue published online: 6 DEC 2002
- Article first published online: 6 DEC 2002
- Cited By
Few published studies have detailed the long-term results of antireflux surgery. The aim of this study was to assess the long-term success of open Lind fundoplication in controlling the symptoms of gastro-oesophageal reflux disease.
One hundred and thirty-two patients with reflux symptoms underwent a primary Lind fundoplication between April 1986 and February 1994; all operations were supervised or performed by one surgeon. The median age at operation was 47 (range 17–77) years. All patients attended for follow-up in the early postoperative period. It was possible to conduct a telephone interview to assess long-term symptom control, at a median time of 9·5 (range 5–13) years following operation, in 112 of the 124 patients who were still alive.
Ninety-one patients underwent oesophageal pH studies before and soon after operation. The oesophageal pH was less than 4 for a mean 14·9 per cent of the time before operation, falling to 2·4 per cent in the early postoperative period (P < 0·001, Wilcoxon test). At early postoperative assessment, two patients complained of mild reflux symptoms and 44 (33 per cent) complained of postfundoplication symptoms (dysphagia, epigastric bloating and early satiety). At telephone interview, 106 patients (95 per cent) were symptom free with regard to heartburn and regurgitation. Six patients have developed recurrent reflux symptoms, in four of whom symptoms are controlled by a proton pump inhibitor. Two patients have required further antireflux surgery, one within 2 months of the first procedure for severe dysphagia and the other for recurrent reflux. Significant postfundoplication symptoms persist (dysphagia with or without gas bloat) in three patients (3 per cent).
Open Lind fundoplication appears to be effective in the long-term control of gastro-oesophageal reflux in 95 per cent of patients and represents a standard against which the long-term results of laparoscopic surgery will need to be compared. © 2000 British Journal of Surgery Society Ltd