• Mehran Anvari and Christopher Allen.
• Centre for Minimal Access Surgery and Department of Medicine, St Joseph's Hospital, McMaster University, Hamilton, Ontario, Canada.
• J. Am. Coll. Surg. 2003 Jan 1; 196 (1): 51-7; discussion 57-8; author reply 58-9.

BackgroundWe conducted an objective followup of 181 patients after laparoscopic Nissen fundoplication during a 5-year period after surgery.Study DesignPatients underwent 24-hour pH recording, esophageal manometry, and symptom score assessment for six gastroesophageal reflux disease symptoms preoperatively and at 6 months, 2 years, and 5 years after surgery.ResultsLaparoscopic fundoplication was associated with a significant (p < 0.0001) increase in lower esophageal sphincter pressure and a significant (p < 0.0001) drop in duration of acid reflux in 24 hours, and symptom score, 6, 24, and 60 months after surgery when compared with preoperative values. Twenty-one patients (12%) have experienced recurrence of reflux-type symptoms, but only six have required repeat surgery. Lower esophageal sphincter tone dropped between 6 months and 5 years after surgery, but was still an effective antireflux barrier. Patient satisfaction with surgery dropped over the 5-year followup but remained high, at 86%, after 5 years.ConclusionsLaparoscopic Nissen fundoplication remains an effective antireflux procedure at 5 years.Copyright 2003 by the American College of Surgeons

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