Trends in laparoscopic anti-reflux surgery: a Korea nationwide study.

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Tytuł:: Trends in laparoscopic anti-reflux surgery: a Korea nationwide study.
Autorzy:: Kim MS; Korea University College of Medicine, Seoul, Republic of Korea.
Oh Y; Korea University College of Medicine, Seoul, Republic of Korea.
Lee JH; Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea.
Park JM; Department of Surgery, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
Kim JJ; Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea.
Song KY; Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea.
Ryu SW; Department of Surgery, Keimyung University School of Medicine, Daegu, Republic of Korea.
Seo KW; Department of Surgery, Kosin University College of Medicine, Busan, Republic of Korea.
Kim HI; Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
Kim DJ; Department of Surgery, The Catholic University of Korea College of Medicine, Seoul, Republic of Korea.
Park S; Division of Upper Gastrointestinal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Inchon-ro 73, Seongbuk-gu, Seoul, 136-705, Republic of Korea. .
Han SU; Department of Surgery, Ajou University School of Medicine, 206 WorldCup-ro, Yeongtong-gu, Suwon, 443-749, Republic of Korea. .
Corporate Authors:: Korean Anti-reflux Surgery Study (KARS) group
Źródło:: Surgical endoscopy [Surg Endosc] 2021 Aug; Vol. 35 (8), pp. 4241-4250. Date of Electronic Publication: 2020 Sep 01.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: 1992- : New York : Springer
Original Publication: [Berlin] : Springer International, c1987-
MeSH Terms:: Gastroesophageal Reflux*/surgery
Hernia, Hiatal*/surgery
Laparoscopy*
Fundoplication ; Humans ; Republic of Korea/epidemiology ; Treatment Outcome
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Contributed Indexing:: Keywords: Complications; Dysphagia; Gastroesophageal reflux disease; Laparoscopic fundoplication; Nissen fundoplication; Trend
Entry Date(s):: Date Created: 20200903 Date Completed: 20211020 Latest Revision: 20211026
Update Code:: 20240104
DOI:: 10.1007/s00464-020-07909-6
PMID:: 32875418
: Czasopismo naukowe

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Background: In 2014, the results derived from the nationwide data of the Korean Anti-reflux Surgery Study (KARS) demonstrated short-term feasibility and safety of anti-reflux surgery. This study aimed to update the longer-term safety and feasibility of laparoscopic anti-reflux surgery up to 1-year follow-up with the KARS nationwide cohort.
Methods: The data of 310 patients with GERD who received anti-reflux surgery up to 2018 were analyzed. Baseline patient characteristics, postoperative symptom resolution, and postoperative complications were evaluated at postoperative 3 months and 1 year using the questionnaire designed by KARS. We divided the patients into two groups according to the operation period (up to and after 2014) to identify changes in the trends of the characteristics of surgical patients and operative qualities.
Results: The typical preoperative symptoms were present in 275 patients (91.7%), and atypical symptoms were present in 208 patients (71.0%). Ninety-seven (35.5%) and 124 patients (46.1%) had inadequate PPI responses and hiatal hernia, respectively. At postoperative 1 year, typical and atypical symptoms were either completely or partially controlled in 90.3% and 73.5.0% of patients, respectively. Moderate-to-severe dysphagia, inability to belch, gas bloating, and flatulence at postoperative 1 year were identified in 23.5%, 29.4%, 23.2%, and 22.0% of patients, respectively. The number of surgical patients continuously increased from 2011 to 2018 in Korea. The proportion of patients with hiatal hernia and comorbidities increased (p < 0.01, p = 0.053), and the operation time decreased significantly (p < 0.01) in the late period (2015-2018) as compared with the early period (2011-2014). Symptom control and complication rate were equivalent between the two periods.
Conclusions: Anti-reflux surgery was effective with > 90% of typical symptom resolution and posed a comparable postoperative complication rate with those in Western studies with mid-term to long-term follow-up. This result supports the feasibility and safety of anti-reflux surgery as a treatment for GERD in the Korean population.

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