|تعداد مشاهده مقاله||12,896,283|
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Clinical Outcome and Recurrence of Open versus Laparoscopic Nissen Fundoplication in the Republic of Kazakhstan during 2010-2021
|Iranian Journal of Medical Sciences|
|مقالات آماده انتشار، اصلاح شده برای چاپ، انتشار آنلاین از تاریخ 18 شهریور 1402 اصل مقاله (1.01 M)|
|نوع مقاله: Original Article(s)|
|شناسه دیجیتال (DOI): 10.30476/ijms.2023.96685.2839|
|Bolatbek Baimakhanov1؛ Shakir Zhurayev1؛ Adil Shokebaev2؛ Nurbol Orynbassar3؛ Nurmakhan Imammyrzayev3؛ Khozybek Kazakhstan3؛ Kuanysh Kanatov3؛ Yevgene Yenin4؛ Gulziya Ismailova* 5|
|1Syzganov National Scientific Center of Surgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan|
|2Department Gastrointestinal Tract and Endocrine Surgery, Syzganov National Scientific Center of Surgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan|
|3Department of the Gastrointestinal Tract and Endocrine Surgery, Syzganov National Scientific Center of Surgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan|
|4Department of Pathomorphology, Cytology, Syzganov National Scientific Center of Surgery, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan|
|5Department of Clinical Specialties, Higher School of Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan|
|Background: Surgical treatment of recurrent gastroesophageal reflux disease (GERD) negatively affects patients’ quality of life (QoL). Determination of risk factors is essential when considering a surgical approach. The present study aimed to evaluate short-term and long-term outcomes of primary laparoscopic Nissen fundoplication (LNF) and open Nissen fundoplication (ONF), as well as the risks of laparoscopic redo fundoplication.|
Methods: A retrospective cohort observational study was conducted from 2010 to 2021 at the National Research Center of Surgery (Almaty, Kazakhstan). Depending on the type of primary GERD surgical correction, 475 patients were stratified into two groups, namely LNF (n=117) and ONF (n=358). The outcomes and associated complications of LNF and ONF surgeries were assessed. The odds ratio of recurrent GERD in terms of risk factors was analyzed as well as post-intervention QoL.
Results: Postoperative complications in ONF surgery were 2.7-fold higher than in LNF (P=0.0001). Moreover, intra-operative complications were higher with ONF surgery (7.7%) than with LNF (1.4%) (P=0.002). In cases with persistent clinical manifestations, the rate of redo fundoplication was the same after failed primary LNF and ONF. The risk factors associated with recurrent GERD, leading to redo fundoplication, were obesity (OR=2.16, P=0.473) and male sex (OR=3.0, P=0.272). One-year after LNF, 88.7% of the patients were satisfied with the outcome of the surgery.
Conclusion: Recurrent symptoms of GERD and the rate of redo fundoplication were associated with obesity and the male sex. Obesity was the main risk factor, necessitating stringent selection of patients for surgical management of the disease.
|Gastroesophageal reflux؛ General surgery؛ Fundoplication؛ Laparoscopy؛ Esophagoplasty|
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