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Surgical Endoscopy
Published in: Surgical Endoscopy 12/2010

01-12-2010

Population-based trend analysis of laparoscopic Nissen and Toupet fundoplications for gastroesophageal reflux disease

Authors: U. Zingg, L. Rosella, U. Guller

Published in: Surgical Endoscopy | Issue 12/2010

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Abstract

Background

The Nissen and Toupet fundoplications are the most commonly used techniques for surgical treatment of gastroesophageal reflux disease. To date, no population-based trend analysis has been reported examining the choice of procedure and short-term outcomes. This study was designed to analyze trends in the use of Nissen versus Toupet fundoplications, and corresponding short-term outcomes during a 10-year period between 1995 and 2004.

Methods

A trend analysis was performed of 873 patients (Toupet: 254 patients, Nissen: 619 patients) prospectively enrolled in the database of the Swiss Association for Laparoscopic and Thoracoscopic Surgery.

Results

The frequency of the performed techniques remained stable during the observation period (p value for trend 0.206). The average postoperative and total length of hospital stay both significantly decreased during the 10-year period from 5.6 to 4.0 days and 6.8 to 4.8 days, respectively (both p values for trend <0.001). The average duration of surgery decreased significantly from 141 minutes to 121 minutes (p value for trend <0.001). There was a trend towards less complications in later years (2000–2004) compared to early years (1995–1999, p = 0.058). Conversion rates were significantly lower in later years compared with early years (p = 0.004).

Conclusions

This is the first trend analysis in the literature reporting clinical outcomes of 873 prospectively enrolled patients undergoing Nissen and Toupet fundoplications during a 10-year period. The proportion of laparoscopic Nissen versus Toupet fundoplications remained stable over time, indicating that literature reports of the advantages of one procedure over the other had minimal influence on surgeons’ choice of technique.
Length of hospital stay, duration of surgery, morbidity, and conversion rate decreased over time, reflecting the learning curve. Clearly, patient outcomes have much improved during the 10-year observation period.
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Metadata
Title
Population-based trend analysis of laparoscopic Nissen and Toupet fundoplications for gastroesophageal reflux disease
Authors
U. Zingg
L. Rosella
U. Guller
Publication date
01-12-2010
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 12/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-010-1093-z

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