24H pHmetric Evaluation of GERD after Laparoscopic Nissen-Rossetti Fundoplication: 1 Year Follow Up. 21st National Congress of the Italian Polyspecialist Society of Young Surgeons (IPSYS). June 15-18, 2008, Perugia

Introduction: Laparoscopic Nissen Fundoplication is the gold standard for surgical treatment of GERD. Results 1 year after Nissen-Rossetti Fundoplication is reported. Material and Methods: 92 N-R performed, underwent to a pre and postoperative work-up including symptom quest, barium meal, endoscopy and 24-h pH-metry. 64 patients were considered. 92% of treated patients was asymptomatic. Results: 24-h pH-metry was positive in 3 cases: total number of reflux episodes decreased from 40,00 ± 4,5 to 8,79 ± 2,3; the duration of longest episode decreased from 98,73 mins to 11,50 mins; the percentage of time with esophageal pH<4 was 1,8% ± 0,7 for total time, 1,4% ± 1,3 for supine time and 1,88% ± 0,6 for erect time; DeMeester & Johnson’s Score decreased from 79,4 ± 1,0 to 13,2 ± 3,1; endoscopy with histological samples evidenced a strong improvement of esophagitis, a stationary aspect of Barrett’s Esophagus in 1 patients, a complete regression in 2 patients; 17 patients complained dysphagia spontaneously relieved within 1 month; there was no need of reintervention, only one patient recurred to PPI therapy and one to benzodiazepine administration, however 95% of patients were completely satisfied by surgical results. Conclusion: Based on our personal experience, laparoscopic N-R Fundoplication can totally control acid reflux after 1 year with relatively few complications and a high degree of patient satisfaction.