Comparison of Outcomes of Anterior Wrapping and Posterior Wrapping in Laparoscopic Fundoplication

DOI Web Site
  • Sakai Kohei
    Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • Furukawa Taizo
    Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • Kimura Osamu
    Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • Higashi Mayumi
    Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • Fumino Shigehisa
    Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • Aoi Shigeyoshi
    Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
  • Tajiri Tatsuro
    Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine

Bibliographic Information

Other Title
  • 腹腔鏡下噴門形成術におけるanterior wrappingとposterior wrapping治療成績の検討
  • フククウキョウ カ フンモン ケイセイジュツ ニ オケル anterior wrapping ト posterior wrapping チリョウ セイセキ ノ ケントウ

Search this article

Description

Purpose: The operative method of fundoplication for gastroesophageal reflux disease (GERD) is divided into anterior wrapping (AW), such as Dor fundoplication, and posterior wrapping (PW), such as Toupet and Nissen fundoplications. Our institute introduced laparoscopic fundoplication in 2002. AW was performed until 2010, and PW has been performed since 2011. We examined the outcomes of AW and PW.<br> Methods: We examined 33 cases that we encountered from 2002 to 2013 and compared them retrospectively. The median age was 4 years (0-39 years), 26 patients were boys, and 7 were girls.<br> Results: Twenty-four patients showed severe motor and intellectual disabilities, six had congenital hiatal hernia, and three showed postoperative esophageal atresia. AW (Dor) was performed in 18 patients, and PW (Nissen fundoplication for 9 patients, Toupet fundoplication for 6 patients) was performed in 15 patients. Compared with AW (p < 0.05), PW is associated with significantly reduced blood loss and operation time. Recurrence was observed in three patients subjected to AW (16.7%) and in 1 patient subjected to PW (6.7%). The recurrence rate was significantly reduced in the PW group. There was no significant difference between Nissen and Toupet fundoplications in terms of recurrence. For the 3 patients who showed recurrence in the AW group, 1 underwent reoperation and 2 were treated conservatively. One patient who underwent Toupet fundoplication showed recurrence.<br> Conclusions: In our institute, PW was found to be associated with significantly less operation time and intraoperative blood loss than AW. PW is a better procedure than AW for GERD. It was considered important to determine the condition of the patient in the selection of PW as the operative method. In particular, Nissen fundoplication is useful for patients with severe motor and intellectual disabilities.

Journal

Related Projects

See more

Keywords

Details 詳細情報について

Report a problem

Back to top