Ann Surg Treat Res.  2018 Jun;94(6):298-305. 10.4174/astr.2018.94.6.298.

Nationwide survey of partial fundoplication in Korea: comparison with total fundoplication

Affiliations
  • 1Department of Surgery, Korea University College of Medicine, Seoul, Korea. ppongttai@gmail.com
  • 2Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
  • 3Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 4Department of Surgery, Chosun University College of Medicine, Gwangju, Korea.
  • 5Department of Surgery, Kosin University College of Medicine, Busan, Korea.
  • 6Department of Surgery, Ajou University School of Medicine, Suwon, Korea.

Abstract

PURPOSE
Laparoscopic total fundoplication is the standard surgery for gastroesophageal reflux disease. However, partial fundoplication may be a viable alternative. Here, we conducted a nationwide survey of partial fundoplication in Korea.
METHODS
The Korean Anti-Reflux Surgery study group recorded 32 cases of partial fundoplication at eight hospitals between September 2009 and January 2016. The surgical outcomes and postoperative adverse symptoms in these cases were evaluated and compared with 86 cases of total fundoplication.
RESULTS
Anterior partial fundoplication was performed in 20 cases (62.5%) and posterior in 12 (37.5%). In most cases, partial fundoplication was a secondary procedure after operations for other conditions. Half of patients who underwent partial fundoplication had typical symptoms at the time of initial diagnosis, and most of them showed excellent (68.8%), good (25.0%), or fair (6.3%) symptom resolution at discharge. Compared to total fundoplication, partial fundoplication showed no difference in the resolution rate of typical and atypical symptoms. However, adverse symptoms such as dysphagia, difficult belching, gas bloating and flatulence were less common after partial fundoplication.
CONCLUSION
Although antireflux surgery is not popular in Korea and total fundoplication is the primary surgical choice for gastroesophageal reflux disease, partial fundoplication may be useful in certain conditions because it has less postoperative adverse symptoms but similar efficacy to total fundoplication.

Keyword

Fundoplication; Partial fundoplication; Gastroesophageal reflux
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