Authors: J S Wu D L Dunnegan D R Luttmann N J Soper
Publish Date: 2014/04/08
Volume: 10, Issue: 12, Pages: 1164-1170
Abstract
Methods Since first performing LNF we have consistently utilized a 25cm wrap performed over a 50 Fr dilator Other technical details have varied and these are reviewed in terms of early clinical outcome Of 105 consecutive patients undergoing LNF two were converted to open operation 2 In the remaining 103 patients with ≥3month followup mean 17 months the initial 46 group 1 45 mean age ± SEM = 47 ± 2 years had selective division of the SGV crural closure and wrap fixation In this group 32 patients 70 underwent SGV division 30 patients 65 had crural closure 10 anteriorly/20 posteriorly and 14 patients 30 had the wrap sutured to the crus During the subsequent 57 LNFs group 2 55 47 ± 2 years all patients underwent SGV division posterior crural closure and suture of the wrap to the crusResults Clinical outcome at ≥3 months was compared between the two groups The frequencies of mild reflux symptoms meteorism and persistent dysphagia were similar in the two groups However the incidences of slippage of the wrap into the chest and the need for secondary intervention esophageal dilatation and/or laparoscopic reoperation decreased significantly from 15 and 13 of patients in group 1 respectively to no occurrences in group II Chisquare analyses revealed that combinations of these technical variables were significantly related to the improved outcome in group II
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