Long-term gastrointestinal symptoms after laparoscopic Nissen fundoplication

Patients who have undergone fundoplication may be at risk for recurrent gastroesophageal reflux and may experience postoperative gastrointestinal symptoms. We investigated the long-term symptomatic outcome after laparoscopic Nissen fundoplication. Between 1993 and 1998 we treated 60 patients with laparoscopic fundoplication for gastroesophageal reflux disease. Signs of recurrence and gastrointestinal symptoms were assessed in 55 (92%) patients after a minimum follow-up of 1 year (median: 3.6 years). At follow-up, 52 patients (95%) were completely free of reflux symptoms. Mild gastrointestinal symptoms (flatulence, 60%; early satiety, 51%; meteorism, 42%; inability to vomit, 27%; dysphagia, 25%; diarrhea, 25%; epigastric pain, 24%; inability to belch, 22%) were found in a total of 51 patients (93%). Disturbing symptoms occurred in only 9 patients (16%). Laparoscopic Nissen fundoplication results in excellent control of gastroesophageal reflux disease at long-term follow-up. Despite a high rate of gastrointestinal symptoms, patient satisfaction showed the operation to be effective and well tolerated.