TITLE

LIFE THREATENING AND FATAL COMPLICATIONS IN FUNDOPLICATION: ANALYSIS OF 11 974 PATIENTS

AUTHOR(S)
Salo, J.A.; Rantanen, T.K.; Sipponen, J.T.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA19
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The number of fundoplications has increased since the introduction of the laparoscopic technique. Usually excellent reports from specialised centres are reported and no comprehensive nationwide studies of dangerous complications of fundoplication have been made. We have analysed all the serious and fatal complications after both open and laparoscopic fundoplication in all primary fundoplications performed between 1.1.1987 and 31.12.2000. Altogether 11 974 fundoplications were performed in Finland (population ca. 5 million), (5975 open and 5999 laparoscopic). Patients undergoing open fundoplication had more operative risk factors. According to the Central Statistical Office, Patient insurance Association and National Research and Development Centre for Welfare and Health there were altogether 65 (0.54%) fatal or life-threatening complications; 40 (0.67%) in laparoscopic and 25 (0.42%) in open (p = n.s.). The complications were severe infections caused by perforation of the oesophagus or Fundus, intestinal perforation/intra-abdominal abscess, several re-operations due to haemorrhage requiring massive transfusion, total oesophageal obstruction leading to total parenteral nutrition with/without re-operation, incarceration of the intestine after hiatal repair, and lung embolism. The total mortality was 15 (0.13%). Five patients died in laparoscopic (mortality 0.08%) and 10 in open fundoplication (mortality 0.17%, p = n.s.). Laparoscopic fundoplicotion had 35 (0.58%) non-fatal life-threatening complications, which is significantly more (p < 0.01) than in open 15 (0.25%). In conclusion the current mortality of fundoplication is relatively Iow (0.13%), but still, almost every 200 patient suffers from life-threatening and/or fatal complications. There is no significant difference in the mortality between laparoscopic and open fundoplication, but laparoscopic fundoplication is associated with significantly more life-threatening complications. These facts must be...
ACCESSION #
9747387

 

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