Laparoscopic versus open fundoplication with acid suppression/duodenal diversion technique for long segment Barrettís esophagus

Abstract

Introduction:

In patients with long Barrett esophagus we have suggested to perform fundoplication with antrectomy, vagotomy and Roux-en-Y duodenal diversion however it could be associated with complications and side effects.

Objective:

The objective of this study is to compare open versus laparoscopic surgery for early and early postoperative complications, mortality and distant outcomes.

Material and method:

We compare 2 cohorts of patients, 73 patients with open surgery and 53 patients, who underwent laparoscopic surgery using the same technique. Only patients with Long Barrett were included. They are clinically monitored in the early and late postoperative period, with endoscopy and histology at long term follow-up (3-5 years). The results were evaluated in terms of early and late complications, the quality of life and patient satisfaction were analyzed. For the analysis we used t-student considering a P < .05 as significant.

Results:

As for early complications, there were no significant differences in both groups. There was no postoperative mortality. In the late complications, the total complications are not significantly different between the two groups (only their causes and characteristics changed) neither in terms of Visick's classification and the quality of life score

Conclusion:

The fundoplication, with laparoscopic acid suppression and duodenal diversion, presents similar short-term and long-term results than open surgery, with the benefits of a mini-invasive procedure.