外科ジャーナル

Outcomes of Laparoscopic Nissen Fundoplication

Abstract

Moses Kayima1, Francis Basimbe2*, Ignatius Kakande3, Hussein Bili4, Jama Abdisamad4, Laurita Nakyagaba5 and Sauya Nannungi5

Background: Anti-reflux surgery has been shown to give superior quality of life compared to PPIs. Laparoscopic Nissen Fundoplication (LNF) is the most common surgical treatment for GERD and Hiatus hernia with good patient satisfaction rates. However, some complications following this intervention have been reported in various studies but these have not been studied in sub-Saharan Africa.

Methods: Cross sectional study that utilized secondary data of 70 patients who underwent LNF at St. Francis Hospital Nsambya from September 2020 to September 2022. The study determined the demographic characteristics, pre-operative symptoms, endoscopic findings and outcomes of these patients during a follow up period of 2months post-surgery.

Results: 62.9% of the patients in this study were females, the mean age was 39.7 years and 68.6% were from central region. The mean BMI was 25.9kg/m², 90% had a BMI of<30 and only 10% were obese. The most common GERD symptoms were epigastric pain (35.3%) and heart burn (19.6%). Major endoscopic findings included Hiatus hernia (45.1%) and GERD (28.8%). The mean length of hospital stay was 2 days (SD 1 day), patients were able to return to work after a mean duration of 3.1 weeks, 90% of patients had improvement in GERD symptoms with 35.7% completely resolved symptoms and 54.3% partially resolved symptoms. Only 10% had no change in GERD symptoms and there was no case of re-operation.

Conclusion: The outcomes of LNF in our study were good and comparable in terms of recovery, return to work, with low complication rates.