Original article
Technical aspects of the posterior partial fundoplication – impact on the results of surgical treatment of gastroesophageal reflux

Aim: To present technical aspects of the posterior partial fundoplication and the results of surgical treatment of gastrointestinal reflux. Material and methods: 174 patients (102 females and 72 males, aged 22-64 years) were listed for a laparoscopic antireflux procedure. Typical clinical symptoms of GERD were accompanied by endoscopically and histologically proved inflammation of the lower esophagus, estimated according to the Savary-Miller score. In 156 patients (89.7%) radiology and endoscopy showed the presence of hiatal hernia. In 28 (16%) cases complaints related to incidents of strangulation were reported, while 33 (19%) patients suffered from laryngological and pulmonary disorders due to GERD. Laparoscopic Toupet procedure was performed as a method of choice. The follow-up period ranged from 1 months to 6 postoperative years. Results: In 165 cases (95%) it was possible to perform the laparoscopic technique. In 9 cases conversion to the traditional technique was necessary. 19 patients (11%) suffered from transitory postoperative dysphagia lasting no longer than 1 month. All patients were free from the symptoms of gastroesophageal reflux. None of the patients required any additional pharmacological treatment except the patients with Barrett esophagus. 86% patients were very satisfied with the results of the treatment, 10% moderately satisfied and 4% of the patients had expected better results of the operation. Conclusions: Partial posterior laparoscopic fundoplication is an efficient way of treatment in the cases of gastroesophageal reflux. The classical surgical antireflux methods applied to laparoscopy yield very good results. This method of treatment proved to be very encouraging.