- Meeting abstract
- Open Access
Laparoscopic Toupet fundoplication: a alternative chance in elderly patients with GERD
© Ferronetti et al; licensee BioMed Central Ltd. 2013
- Published: 16 September 2013
- Elderly Patient
- Esophageal Motility
- Esophageal Manometry
- Time Fraction
- Association Probability
Gastro-esophageal reflux disease (GERD) is one of the most frequent diseases of the upper gastro-enteric tract and incidence increases during lifetime . In elderly patients  with a good LES basal tone and good peristalsis, evaluated with esophageal manometry, and even with a long exposure time fraction and a correlation between episodes of reflux and symptoms (SAP - Symptom Association Probability), evaluated with 24h pH-metry , severe and refractory symptoms or intolerance to a conservative treatment, had a good response after a laparoscopic 270° fundoplication (Toupet technique); Toupet's technique seems to offer good results such as Nissen-Rossetti fundoplication in terms of symptom control in a short-term evaluation [4–7].
We drove a prospective study in a period from March 2012 to March 2013, in which 13 elderly patients were treated with VLP Toupet fundoplication. Of these, 11 (84,6%) completed the follow up to six months, while 2 (16,4%) have not respected the post-operative protocol.
Patient age > 65
Long-term diagnosis of GERD
Severe symptoms with conservative treatment
Good LES basal tone and good esophageal motility
The patients have been preliminarily submitted to a 24 hours pH-metry and to an esophageal manometry.
The study foresaw a follow up of six months, that consisted in the repetition of 24 hours pH-metry and manometry one month and six months after the surgical intervention.
The results of study shows that after the intervention there are appreciable improvements, because all patients refer a meaningful decrease of symptoms severity, without post-operative disphagia. No manometric alterations and improvements of 24h ph-matric values were present in all cases.
Laparoscopic Toupet fundoplication seems to be a good alternative in selected elderly patients with severe symptoms of GERD, offering similar results of Nissen-Rossetti fundoplication .
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