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Therapeutic effect of laparoscopic fundoplication for GERD-related disease in the elderly

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Abstract

Background

It is anticipated that surgical treatment for gastro-esophageal reflux disease (GERD) in the elderly will increase. This time, using propensity score matching, we examined the results of laparoscopic fundoplication (LF) for GERD-related diseases in the elderly.

Methods

Of 302 cases which underwent initial LF for GERD-related diseases during the period from June 2008 to February 2019, we classified them into elderly (65 years of age or older) and non-elderly groups (64 years of age or younger). 57 cases each were extracted upon performing propensity score matching regarding five factors including: gender; body mass index; esophageal hiatal hernia; extent of reflux esophagitis; and the use of mesh.

Results

With regard to the preoperative disease status, the pH < 4 holding time was indicated as 2.8% (0.5–10.7%) in the elderly group and 3.4% (0.6–8.0%) in the non-elderly group, with no difference in terms of the illness period as well (p = 0.889 and p = 0.263, respectively). Although there was no difference in terms of the operative time (155 vs. 139 min, p = 0.092) and estimated blood loss (both ≒ 0 ml, p = 0.298), postoperative hospital stay was prolonged in the elderly group [7 (7–9) vs. 7 (7–7), p = 0.007]. On the other hand, esophageal hiatal hernia, reflux esophagitis, and acid reflux time in the esophagus were all improved following surgery in both groups (p < 0.001 in both groups).

Conclusion

The treatment results of LF for GERD-related diseases in the elderly were as good as those in the non-elderly, indicating possible safe implementation.

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Authors and Affiliations

  1. Department of Surgery, Jikei University School of Medicine, 3-25-8 Nishishinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Masato Hoshino, Nobuo Omura, Fumiaki Yano, Kazuto Tsuboi, Se Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Yuki Sakashita, Naoko Fukushima & Hideyuki Kashiwagi

  2. Department of Surgery, National Hospital Organization, Nishisaitama-Chuo National Hospital, Saitama, Japan

    Nobuo Omura

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  1. Masato Hoshino
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  2. Nobuo Omura
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  3. Fumiaki Yano
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  4. Kazuto Tsuboi
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  5. Se Ryung Yamamoto
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  6. Shunsuke Akimoto
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Correspondence to Masato Hoshino.

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Conflict of interest

Drs. Masato Hoshino, Nobuo Omura, Fumiaki Yano, Kazuto Tsuboi, Se Ryung Yamamoto, Shunsuke Akimoto, Takahiro Masuda, Yuki Sakashita, Naoko Fukushima and Hideyuki Kashiwagi have no conflicts of interest or financial ties to disclose.

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Hoshino, M., Omura, N., Yano, F. et al. Therapeutic effect of laparoscopic fundoplication for GERD-related disease in the elderly. Gen Thorac Cardiovasc Surg 70, 72–78 (2022). https://doi.org/10.1007/s11748-021-01713-2

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  • DOI: https://doi.org/10.1007/s11748-021-01713-2

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