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Wednesday January 28 "Key-Hole" Surgery Helps Reflux NEW YORK (Reuters) -- Laparoscopic surgery on the esophagus for the treatment of severe gastroesophageal reflux disease (GERD) is showing a success rate of about 97% at the one-year mark, according to a Pennsylvania physician. GERD is caused by the backflow of stomach contents into the esophagus, a condition that can cause burning pain. In severe cases, some patients may be candidates for fundoplication, a surgical procedure that involves suturing part of the stomach around the lower part of the esophagus to prevent such reflux. This procedure usually involves major surgery. But Dr. Rodney J. Landreneau of Allegheny University in Pittsburgh is using laparoscopy -- a minimally invasive surgery that generally is associated with a quicker recovery and fewer complications -- for a new fundoplication technique. He reported his results at the 34th annual meeting of the Society of Thoracic Surgeons in New Orleans this week. Landreneau and colleagues performed laparoscopic fundoplication in nearly 200 patients with GERD that did not respond to medical treatment. Landreneau reported that patients experienced a 280% improvement in sense of well-being after the procedure, and 94% to 97% reported relief of GERD symptoms. All but 2 out of 58 showed improvement by manometry, a measure of pressure in the stomach. There were no deaths related to laparoscopic fundoplication, but there was one reported stroke in an elderly patient. The technique resulted in stomach perforations in two patients early on in the series, but none recently. Landreneau told Reuters that the procedure initially took about 150 minutes to perform, but that he accomplished the last 60 procedures in less than one hour. It is "almost" an outpatient procedure, he said. "It's more a matter of my comfort level," he explained, "but these patients are pretty sore" after the procedure. Landreneau emphasized the importance of preoperative counseling of the patient regarding the occurrence of dysphagia -- trouble swallowing -- after the procedure. Post-operatively, patients are maintained on a soft diet for about six weeks, until the esophageal swelling subsides. "Although surgical options should not be examined until all other treatment options have been tried," said the surgeon in a statement, "medical care providers and health insurance programs should begin viewing minimally invasive surgery as a viable approach for the treatment of GERD." Judith Richards [log in to unmask]