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

Abstract

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. 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. With regard to the preoperative disease status, the pH\u2009<\u20094 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\u2009=\u20090.889 and p\u2009=\u20090.263, respectively). Although there was no difference in terms of the operative time (155 vs. 139 min, p\u2009=\u20090.092) and estimated blood loss (both ≒ 0 ml, p\u2009=\u20090.298), postoperative hospital stay was prolonged in the elderly group [7 (7–9) vs. 7 (7–7), p\u2009=\u20090.007]. 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\u2009<\u20090.001 in both groups). 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.