The comparison of nissen rosetti techniques and floppy nissan techniques in laparoscopic reflux surgery

SUMMERY The Comparison of Nissen Rosetti Techniques and Floppy Nissan Techniques in Laparoscopic Reflux Surgery Purpose: Laparoscopicreflux surgery which is significantly under control the symptoms of gastroesophageal reflux is surgical technique; however, it has some side effects. In this study, we aimed that Nissan and Rosetti fundoplication which are the laparoscopic fundoplication procedures made due to gastroesophageal reflux disease were mutually evaluated with regard to the short-term results (surgical time, complications, the patient's length of stay in hospital)and long-term results (subjective and pathological acid reflux, would disappear in terms of displaying endoscopic respect such as the disappearance of symptoms and improved quality of life). In this study, In contrast to the literature, In this study, contrary to literature, patients were operated by a single surgeon, and two different procedures have been applied to patients; moreover, their assessment is made by a single observer. Materials and Methods:Between March 2010 - March 2013, 126 patients with complaints of gastroesophageal reflux admitted tothe Cukurova University Faculty of Medicine, Department of General Surgery, Balcalı Hospital's clinic were evaluated. According to the results of endoscopy, 80 patients with erosive reflux disease as well as hiatal hernia underwent laparoscopic nissan and rosetta operation randomized controlled way by the same surgeon whose name is Dr. Parsak. In the preoperative and postoperative period, a survey was conducted to patients. This survey questioned specific and nonspecific gastrointestinal reflux complaints, the frequency and severity of these complaints, and patients' satisfaction with their surgery in the postoperative period. Wilcoxon test, Kruskal-Wallis analysis of variance, Spearman's correlation coefficient, and Mann-Whitney U were used for statistical analysis. Results:According to survey results, Dysphagia 10%, regurgitation 11.3%, burning 16.2%, flatulence 35%, belch 11.3%, diarrhea 11.3%, abdominal pain 73.8%,vomiting 1.3%, and unable to belch 20% was found in the postoperative period. While repeated complaints of patients were 7.5%, a history of drug use patients were 8.8%. Moreover; it was observed that all the findings except for abdominal pain and difficulty in swallowing has decreased in the postoperative period. Additionally, in the postoperative period, inability oral gas extract was among the newly emergent symptoms. It was concluded that duration of symptoms did not affect the level of satisfaction, and that regurgitation, bloating and burning complaints was more frequent in patients with longer duration of symptoms; add to this, there was no relationship between gender and education and satisfaction and complaints in postoperative period. Patients 92.5% are satisfied with the current situation, and again 92.5% were sympathetic to surgery. Consequently, when we compare patients who underwent Nissan operation with other group patiens who underwent Rosetti operation, there were no differences with respect to symptoms and satisfaction except for operation time. Discussion:Although Laparoscopic reflux surgery is an effective method for controlling gastroesophageal reflux disease, some nonspecific gastrointestinal complaints are seen in the postoperative period. However; this does not decrease the rate of satisfaction owing to the scarcity of their frequency and degree. In our study, there were no remarkable differences between Nissen fundoplication and laparoscopic Rosetti fundoplication except for operation time. On the other hand, to give final judgment about this topic, more studies are needed. Keywords: Laparoscopic Nissen fundoplication, Laparoscopic fundoplication Rosetti, postoperative gastrointestinal complaints