Utilization of laparoscopic antireflux surgery at a single Veterans Affairs facility compared with the Veterans Affairs national trend
| Autor: | Sherry M. Wren, Murray Kown, Bassem Y. Safadi |
|---|---|
| Rok vydání: | 2003 |
| Předmět: |
Laparoscopic surgery
medicine.medical_specialty Hospitals Veterans medicine.medical_treatment MEDLINE Fundoplication Health care otorhinolaryngologic diseases medicine Humans Laparoscopy Veterans Affairs Antireflux surgery medicine.diagnostic_test Esophageal disease business.industry General surgery General Medicine medicine.disease United States digestive system diseases Surgery United States Department of Veterans Affairs Gastroesophageal Reflux GERD business |
| Zdroj: | The American Journal of Surgery. 186:505-508 |
| ISSN: | 0002-9610 |
| Popis: | Background The widespread use of laparoscopy in the early 1990s has led to an increase in the utilization of antireflux procedures for the treatment of gastroesophageal reflux disease (GERD). This trend has been observed in the private sector, but not within the Department of Veterans Affairs (VA) health care system. Published data suggest that among patients undergoing antireflux surgical procedures, those in the VA were less likely than those in the private sector to undergo laparoscopic surgery. The objective of this study was to determine the trend in the use of laparoscopic antireflux surgical procedures at our VA facility and compare it with the national VA trend. Methods All antireflux operations performed at our VA facility from 1991 to 2002 were recorded along with techniques used. National VA data on the utilization of antireflux procedures from 1991 to 1999 was extracted from a recent publication by Finlayson et al. Results In contrast to the trend observed nationally across VA hospitals, the rate of utilization of antireflux surgery at our VA facility has increased compared with baseline in 1991. Of 83 fundoplications performed from 1991 to 2002, 76 (92%) were attempted or completed laparoscopically. The conversion rate from laparoscopic to open approach was 6.6%. Conclusions We have observed an increase in the utilization of antireflux surgery since 1991 at our VA facility. In addition, most fundoplications were performed laparoscopically. These findings are in contrast to published national VA data. The presence of surgeons with interest in laparoscopy, institutional support, and a dedicated esophageal function laboratory may explain these findings. |
| Databáze: | OpenAIRE |
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