Does the learning phase influence the late outcome of patients with gastroesophageal reflux disease after laparoscopic fundoplication?

Background: Although the degree of surgical experience clearly affects early outcome of laparoscopic antireflux surgery, its influence on long-term results has not been fully evaluated. The aim of this study was to verify whether the initial experience in laparoscopic antireflux surgery could also influence the late clinical outcome. Methods: Clinical and endoscopic findings, together with quality of life, of the first 25 patients successfully submitted to laparoscopic fundoplication were compared with those of 25 matched controls operated on later. Results: At more than 2 years’, follow-up, reflux symptoms, endoscopic findings, use of antisecretory drugs, side effects, and quality of life were not significantly different in both groups, despite a high occurrence of major anatomical failures (three vs one) in the first set of patients. Conclusion: The late clinical outcome of patients with gastroesophageal disease operated on during the learning phase or after gaining experience is not different, provided the surgeon is adequately trained in laparoscopic surgery.