Abstract
Background
Antireflux surgery (ARS) is a well established treatment for GERD (gastroesophageal reflux disease). The present study gives an overview of experience in Austria regarding the frequency of open and laparoscopic ARS and how Austrian departments meet the requirements for surgery.
Methods
A questionnaire was sent to 115 surgical departments in Austria to evaluate in how many institutions antireflux surgery (open and/or laparoscopically) was performed since 1990, and which pre- and postoperative tests were obligatory, optional, or not performed. Units were divided into specialized and nonspecialized.
Results
The laparoscopic approach has gained in importance by about 300% in the past 5 years in the few hospitals performing this procedure. Esophageal manometry and 24-h pH monitoring were rarely done in nonspecialized units, despite the fact that GERD is mainly a functional disorder of the esophagus and stomach. In contrast to the nonspecialized units, the specialized unit performed upper endoscopy, esophageal manometry and 24-h esophageal pH monitoring as obligatory tests.
Conclusions
ARS, both open and laparoscopic, is not commonly performed in surgical departments in Austria but the frequency has significantly increased in recent years. Laparoscopic ARS is a safe procedure in hospitals performing this frequently. Laparoscopic ARS should only be performed in specialized units with significant experience in gastroesophageal diseases, where functional testing of the esophagus can be done.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Bammer T, Hinder R, Klaus A, Klinger P (2000) Five to eight year outcome of the first laparoscopic Nissen fundoplications. J Gastroint Surg 5: 42–47
Bammer T, Freeman M, Shahriari A, Hinder RA, DeVault DR, Achem SA (1999) The outcome of laparoscopic antireflux surgery in patients with endoscopy negative gastroesophageal reflux. Poster presentation at the National Meeting of the AGA in Orlando, FL
Bonavina L, Evander A, DeMeester TR, Walther B, Cheng SC, Palazzo L, Concannon JL (1986) Length of the distal esophageal sphincter and competency of the cardia. Am J Surg 151: 25–34
Carlsson R, Dent J, Watts R, Riley S, Sheikh R, Hatlebakk J, Haug K, de Groot G, van Oudvorst, A, Dalvag A, Junghard O, Wiklund I (1998) Gastro-oesophageal reflux disease in primay care: an international study of different treatment strategies with omeprazole. International GORD Study Group. Eur J Gastroenterol Hepatol 10 119–124
Dallemagne B, Weerts JM, Jehaes C, Markiewicz S, Lombard R (1991) Laparoscopic Nissen fundoplication: preliminary report. Surg Laparosc Endosc 1: 138–143
DeMeester TR (1987) Definition, detection, and pathophysiology of gastroesophageal reflux disease. In: Demeesler TR, Matthews HR (eds) International Trends in General Thoracic Surgery. Mosby, St Louis, pp. 99–127
De Meester TR, Bonavina L, Albertucci M (1986) Nissen fundoplication for gastroesophageal reflux disease. Evaluation of primary repair in 100 consecutive patients. Ann Surg 204: 9–20
Eypasch E, Wood-Dauphinée S, Williams JI, Ure B et al. (1993) Der Gastrointestinale Lebensqualitätsindex. Chirurg 64: 264–270
Glise H, Hallerbäck B (1995) Assessment of outcome after antireflux surgery. Laparosc Surg 2: 60–65
Heckers H, Lübbecke F (1995) Symptomatische Therapie mit Famotidin bei nicht-erosiver gastroösophagealer Refluxkrankheit. Arzneim-Forsch/Drug Res 45: 499–504
Hinder RA, Filipi CJ (1992) The technique of laparoscopic Nissen fundoplication. Surg Laparosc Endosc 2: 265–272
Hinder RA, Filipi CJ, Wetscher G, Neary P, DeMeester TR, Perdikis G (1994) Laparoscopic Nissen fundoplication is an effective treatment for gastroesophageal reflux disease. Ann Surg 220:472–483
Hinder RA, Raiser F, Katada N, McBride PJ, Perdikis G, Lund RJ (1995) Results of Nissen fundoplication. A cost analysis. Surg Endosc 9: 1328–1332
Kamolz T, Bammer T, Pointner R (2000) Predictability of dysphagia after laparoscopic Nissen fundoplication. Am J Gastroenterol 95: 408–414
Kamolz T, Bammer T, Wykypiel jun H, Pasiut M, Pointner R (2000) Quality of life and surgical outcome after laparoscopic Nissen and Toupet fundoplication: One year follow-up. Endoscopy 32:363–368
Klingler PJ, Hinder RA, Cina RA et al. (1999) Laparoscopic antireflux surgery for the treatment of esophageal strictures refractory to medical therapy. Am J Gastroenterol 94: 632–636
Lieberman DA (1987) Medical therapy for chronic reflux esophagitis. Long-term follow-up. Arch Intern Med 147: 1717–1720
Lung RF, Wetscher GF, Raiser F, Glaser K, Perdikis G, Gadenstätter M, Katada N, Filipi CF, Hinder RA (1997) Laparoscopic Toupet fundoplication for gastroesophageal reflux disease with poor esophageal body motility. J Gastrointest Surg 1: 301–308
Lundell LR, Miettinen P, Myrvorld HE, Pedersen SA, Liedman B, Hatlebakk JG, Janatuinen E, Levander K, Karlsson J, Lamm M, Wiklund I (2000) The Nordic GERD Study Group: Continued (5 year) follow-up of a randomised clinical study comparing antireflux surgery and omeprazole in gastro-esophageal reflux disease. Europ J Gastroenterol Hepatol 12: 879–887
Luostarinen ME, Isolauri JO (1999) Surgical experience improves the long-term results of Nissen fundoplication. Scand J Gastroenterol 34: 117–120
Nissen VR (1956) Eine einfache Operation zur Beeinflussung der Refluxoesophagitis. Schweizer Med Wochenschrift 86: 590–592
Perdikis G, Hinder RA, Lung RJ, Raiser F, Katada N (1997) Laparoscopic Nissen fundoplication: where do we stand?. Surg Laparosc Endosc 7: 17–21
Rantanen TK, Halme TV, Luostarinen ME (1999) The long term results of open antireflux surgery in a community-based health care center. Am J Gastroentero 94: 1777–1781
Robinson MG, Orr WC, McCallum R, Nardi R (1987) Do endoscopic findings influence response to H2 antagonist therapy for gastroesophageal reflux disease? Am J Gastroenterol 82: 519–522
Spechler SJ (1992) Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans. N Engl J Med 326: 786–729
Spechler SJ (1992) Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans. The Department of Veterans Affairs Gastroesophageal Relfux Disease Study Group. N Engl J Med 326: 786–792
Watson DI, Baigrie RJ, Jamieson GG (1996) A learning curve for laparoscopic fundoplication. Definable, avoidable, or a waste of time? Ann Surg 224: 198–203
Watson DI, Jamieson GG, Baigrie RJ, Mathew G, Devitt PG, Game PA, Britten-Jones R (1996) Laparoscopic surgery for gastro-esophageal reflux: beyond the learning curve. Br J Surg 83: 1284–1287
Wetscher GJ, Glaser K, Hinder RA et al. (1997) Respiratory symptoms in patients with gastroesophageal reflux disease following medical therapy and following antireflux surgery. Am J Surg 174: 639–642
Zaninotto G, DeMeester TR, Schwizer W, Johansson KE, Cheng SC (1988) The lower esophageal sphincter in health and disease. Am J Surg 155: 404–111
Author information
Authors and Affiliations
Additional information
Online publication: 3 May 2002
Rights and permissions
About this article
Cite this article
Bammer, T., Kamolz, T., Pasiut, M. et al. Austrian experiences of antireflux surgery. Surg Endosc 16, 1350–1353 (2002). https://doi.org/10.1007/s00464-001-0076-5
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s00464-001-0076-5