81 ANTI-REFLUX SURGERY: TOUPET AND DOR TECHNIQUES

Abstract   Gastroesophageal reflux disease (GERD) is one of the most important digestive disorders, in view of the high incidence, intensity of symptoms and severity of complications. GERD is probably one of the most prevalent diseases in the world that compromises quality of life. It is a common disease that affects between 20–40% of the population of the United States of America at least weekly. In Brazil, the incidence is 12%, corresponding to 20 million individuals. Methods Prospective and retrospective cohort study, which aims to assess the regression of symptoms in patients undergoing surgical technique to correct GERD. The present study was carried out in Natal, Rio Grande do Norte, Brazil, in two hospitals: one in the private network and another study at the State University Hospital, with 130 patients between 2014 and 2020. The study population consisted of patients with GERD confirmed by clinical symptoms, upper gastrointestinal endoscopy, manometry and/or pH monitoring, with the inclusion criteria: patients with GERD refractory to clinical treatment, with hiatus hernia, with atypical symptoms and/or need for surgical intervention. Results We studied 130 patients undergoing GERD correction surgery, 122/130 (93%) Nissen-Toupet, 03/130 (2%) Collis-Dor, 03/130 (2%) Dor and 02/130 (1.5%) Collis-Toupet, with 18/130 (13%) REDO Nissen to Toupet, 13/130 (10%) with mesh reinforcement (TABLE-I) and 01/130 (0.7%) performed Toupet + VSS + gastroenteroanastomosis. In addition, 45/123 (36%) did not have hiatus hernia and 78/123 (63%) did, 40/78 (51%) type 01, 14/78 (17%) type 02 and 18/78 (23%) type 03; 107/130 (82%) performed a manometric study. In short-term complications, 02/130 (1.5%) presented gas bloat syndrome, 01/130 (0.7%) grade 1 dysphagia, fistula 01/130 (0.7%) and mortality 01/130 (0,7%). Conclusion In conclusion, it is observed that the partial fundoplication technique, Toupet and Dor, maintains a competent anti-reflux mechanism with the advantage of reducing postoperative dysphagia, the inability to belch and gas bloat syndrome, in addition to decreasing the rates of postoperative recurrence.