Email updates

Keep up to date with the latest news and content from BMC Surgery and BioMed Central.

This article is part of the supplement: Selected articles from the XXV National Congress of the Italian Society of Geriatric Surgery

Open Access Research article

GERD in elderly patients: surgical treatment with Nissen-Rossetti laparoscopic technique, outcome

Giovanni Aprea1*, Antonio Ferronetti1, Alfonso Canfora1, Fabrizio Cardin2, Antonio Giugliano1, Francesco Guida1, Antonio Braun1, Melania Battaglini Ciciriello1, Federica Tovecci1, Giovanni Mastrobuoni1 and Bruno Amato1

Author affiliations

1 Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, University “Federico II” of Naples, Via Pansini, 5 - 80131 – Naples, Italy

2 Department of Surgical and Gastroenterological Sciences, Padova University Hospital, Italy, Via Giustiniani n.2, 35126 Padova, Italy

For all author emails, please log on.

Citation and License

BMC Surgery 2012, 12(Suppl 1):S4  doi:10.1186/1471-2482-12-S1-S4

Published: 15 November 2012

Abstract

Background

The gastro-esophageal reflux disease (GERD) is one of the most frequent disease of the upper gastro-entheric tract. Surgical treatment is reserved to selected patients, affected by severe forms of disease and/or without compliance to medical therapy.

In 95%-60% of the patients submitted to surgical antireflux intervention, a notable improvement of the quality of life is observed.

Functional evaluations performed on pre and post – surgical pHmetric and manometric examination have provided new acquisitions about improvements in the restoration of anatomical and functional integrity of the esophagus-gastric antireflux barrier.

Methods

45 elderly patients with GERD were recruited in a 27 months period. All patients were subjected to laparoscopic Nissen-Rossetti 360° fundoplication. The subjects had a pre-surgical evaluation with:

• 24 hours pHmetry,

• esophageal manometry,

The same evaluation was repeated 1 month and 6 months after surgical intervention.

Results

In our series all patients get benefit from surgical treatment, with an improvement of pHmetric and manometric parameters and a regression of complications of GERD such as Barrett's metaplasia. In 8.33% of patients a PPI therapy was necessary, after the surgical intervention, to control symptoms.

Conclusions

The role of surgery in GERD concerns selected patients. Nissen-Rossetti mini-invasive approach is performed with an acceptable percentage of complications (3%-10%). This technique is associated with a good control of GERD symptoms in a short and middle term and with an improvement of functional parameters, such as pHmetric and manometric.