XXXX : the role of laparoscopic fundoplication.

@entity1 @entity662 @entity355 @entity357 @entity354 @entity1282 @entity258 @entity420 @entity1141
BACKGROUND: To review our early operative results and endoscopic findings after laparoscopic fundoplication for @entity355 ( @entity355 ). METHODS: From January 1995 through December 2000, 49 @entity1 with @entity355 (35 @entity1 and 14 @entity1 ) underwent laparoscopic antireflux surgery. Median age was 54 years (range, 28 to 85 years). No @entity1 had high-grade @entity1141 ; 6, however, had @entity258 . All 49 @entity1 had @entity354 . Heartburn was present in 41 @entity1 (84%), @entity1282 in 16 (33%), epigastric or @entity662 in 9 (18%), and other symptoms in 16 (33%). A Nissen fundoplication was performed in 48 @entity1 and a partial posterior fundoplication in 1. Forty-one @entity1 (84%) had concomitant @entity357 repair. RESULTS: There were no deaths. Complications occurred in 2 @entity1 (4%). Follow-up was complete in 48 @entity1 (98%) and ranged from 1 to 81 months (median, 29 months). Functional results were classified as excellent in 33 @entity1 (69%), good in 9 (19%), fair in 5 (10%), and poor in 1 (2%). Thirty-three @entity1 (67%) underwent postoperative surveillance esophagoscopy with biopsy. Nine @entity1 (18%) had total regression of @entity355 and 3 (6%) had a decrease in total length. In the 6 @entity1 with preoperative @entity258 , @entity1141 was not found in 4, remained unchanged in 1, and progressed to in situ @entity420 in 1. CONCLUSIONS: Laparoscopic fundoplication is effective in controlling symptoms in the majority of @entity1 with @entity355 . While disappearance of @entity355 may occur in some @entity1 , the possibility of developing @entity420 is not eliminated by laparoscopic fundoplication. Therefore, endoscopic surveillance should continue.
