Short And Long Term Complications And Risk Factors Analysis Of Laparoscopic Anti-reflux Surgery For Gastroesophageal Reflux Disease

Objective:Gastroesophageal reflux disease(GERD)is so common in the clinical illness. With the development of the technology of laparoscopy,fundoplication is currently recommended for the management of severe GERD where medical treatment has been unsuccessful. Outcome following laparoscopic fundoplication for gastroesophageal reflux can be measured using objective tests, symptom scores and quality of life measures. Despite improvement in measures, it is still rare on the study of short and long complications. It is not yet reported the improvement of patients with diffternt kinds of surgery.Our study is about short and long complication after fundoplication, which include the improvement of clinical symptoms, complications,the relevant objective tests and patients' s satisfaction after different kinds of surgery.The basic fundoplication includes laparoscopic Nissen(360°) fundoplication?Toupet(270°)fundoplication and Dor(180°)fundoplication. Furthermore, there are no relevant articles on the prevalence and risk factors after laparoscopic fundoplication.Our research also discusses the risk factors' effect on the recurrence of clinical symptoms, such as gender, age, daily habits and medical history.Methods : 180 GERD patients were divided into three groups according to the surgeries they experienced. And fundoplication surgery included laparoscopic Nissen(360°) fundoplication?Toupet(270°)fundoplication and Dor(180°)fundoplication..(1) Observe symptom recurrence of three different groups;(2) Observe complication cases during our follow-up;(3) Observe the relevant objiective tests, such as gastroscope, acid pressure measurement;(4) Compare different situations in different groups.Also, 180 GERD patients were divided into Recurrence group and Non recurrence group according to patients' recovery after laporoscopic fundoplication. Then we studied risk factors affect patiens' symptoms recurrence, such as gender, age, medical history, daily habits and family history.Results1?Follow-up recurrence of symptomsThere is no significant difference in symptoms recurrence during eight months among the three groups. While after eight months, statistical analysis shows that patients experienced Dor fundoplication is much higher than the other two groups on symptoms recurrence.2?ComplicationPatient experienced Nissen fundoplication is much higher than the other two groups on complication appearance.3?Patients' satisficationStatistical analysis shows that patient experienced Toupet fundoplication is much higher than the other two groups on the degree of satisfication.4?Relevant objective testsStatistical analysis shows that patient experienced Nissen fundoplication recovered better than the other two groups on the gastroscope, acid pressure measurement;5?Risk factorsOur study shows that gender, age, medical history, daily habits may have an effect on patients symptoms recurrence after fundoplication.Conclusion1 ? The study found that Nissen fundoplication can effectively relieve patients postoperative recurrence of anti acid symptoms. While after Toupet fundoplication,patients' satisfication is much higer than the other groups. And after Dor fundoplication, patients' complication is much lower than the two other group.2?Risk factors, such as daily habits, smoking and drinking history, medical history,gender, age and BMI, can affect patients' symptoms recurrence after fundoplication.