Cirugia de la enfermedad por reflujo gastroesofagicoEstudio comparativo entre los abordajes laparoscopico y abierto.

Resum

INTRODUCTION: At the present time the complementary explorations allows the diagnosis of the gastroesophageal reflux disease. The effectiveness of the medical treatment along with the appearance of the laparoscopic boarding, will be cause of controversy when valuing itself the indications of the surgery. We considered the following hypothesis: " The clinical and instrumental results of the fundoplication of 360º short and floppy by laparoscopic surgery are superior to those of the short and floppy fundoplication by open surgery ". MATERIAL AND METHODS: The work was developed between November of 1991 and December of 1998, and consists of two groups of patients: - Group I (n=75): fundoplication of 360º short and floppy by laparoscopy in Dr Peset hospital of Valencia. - Group II (n=28): fundoplication of 360º short and floppy by open surgery in the General Universitario hospital of Valencia. We compared, without finding differences, the preoperative parameters what it allows us to know that both groups are homological. RESULTS: The analysis of the peroperative results and the clinical and instrumental pursuit (radiologic study, endoscopy, phmetry and manometry) does not demonstrate differences; whereas in the postoperative one statistically significant differences with respect to the recovery exist. DISCUSSION: The analysis of Literature objectives concordant results as finded by us, emphasizing the differences in favor of the laparoscopic surgery with respect to the postoperative recovery, obtaining a clinical and instrumental controls similars. CONCLUSIONS: The use of the laparoscopic surgery is based on one better postoperative tolerance of the patient, since its effectiveness is similar to the obtained one with the laparotomic boarding.