Impacto de la endoscopia transoperatoria en el índice de complicaciones postquirúrgicas y reintervención en pacientes sometidos a funduplicatura

Abstract

Background: Laparoscopic fundoplication is the surgical treatment of choice in patients with gastroesophageal reflux disease. The most common complication is dysphagia. Performing an intraoperative endoscopy may reduce the complication rate, allowing the anatomy to be assessed. This study aimed to assess the rate of complications and reoperation in patients undergoing laparoscopic fundoplication when performing intraoperative endoscopy. Methods: A total of 160 patients were analyzed in this study. Forty-four patients underwent intraoperative endoscopy (group A), whereas 116 patients did not (group B). We assessed a subgroup of patients classified as complex due to a history of previous hiatal surgery or large hiatal hernia requiring mesh placement. Results: No difference was noted in the rate of operative complications and need for reintervention between groups A and B (2.2% vs. 7.8%, respectively; p = 0.729). The lengths of hospital stay were 1.98 and 2.75 days, respectively (p = 0.037). Twenty-two patients had a history of previous fundoplication surgery, 16 (73%) in group A and 6 (27%) in group B, with no complications in group A and 2 (33.3%) in group B (p = 0.015). Twenty-five patients underwent hiatal hernioplasty with mesh, 18 (72%) in group A and 7 (28%) in group B. Four (16%) patients presented with complications, one (5.5%) in group A and three (42%) in group B (p = 0.022). Conclusions: Performing intraoperative endoscopy does not decrease the rate of complications or reintervention. However, in complex cases, performing intraoperative endoscopy reduces the rate of complications and reintervention.