Thoracoscopic Belsey fundoplication with 5-year outcomes

Abstract

Background: To determine the indications for a minimally invasive thoracic technique in gastroesophageal reflux disease (GERD), we conducted a retrospective review of outcomes with our first 21 thoracoscopic Belsey fundoplications.

Methods: A thoracoscopic Belsey fundoplication was completed in 21 patients (12 males, 9 female; ages, 38-83 years). Preoperative evaluation revealed 13 primary motility disorders, 9 strictures, and 3 epiphrenic diverticuli. Six patients had previous gastric surgery. Sixteen patients underwent 20 ancillary procedures (esophagomyotomy, 14; excision of diverticulum, 2; lung volume reduction, 2; prosthetic diaphragmatic repair, 1; and Thal-Woodward esophagoplasty, 1).

Results: Mean follow-up was 75.6 months (range, 67-85 months). There was one operative death (4.8%). Early morbidity included two esophageal leaks (9.8%). Late morbidity included three patients (15.7%) with persistent dysphagia and five patients (26%) with recurrent GERD.

Conclusion: Thoracoscopic Belsey fundoplication was associated with a high morbidity and recurrence rate in our long-term experience.