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Abstract Gastro-esophageal reflux (GER), recognized as a clinical entity only in mid 1930s, is now the most prevalent upper gastrointestinal disorder in clinical practice. Reflux surgery is entering a new era with the advent of minimally invasive techniques. In our series, there was 90% improvement in heartburn in both open and laparoscopic groups. It is noteworthy that among the patients who improved regarding heartburn, most had at least temporary improvement on proton pump inhibitors preoperatively. Thus we can suggest that improvement on medical treatment could be considered as a predictor to the success of surgery. The total Demeester score improved dramatically in both open and laparoscopic groups with no statistically significant difference between the two groups (p>0.05) Regarding esophageal manometry in our series, there was a post operative relatively equal increase in both groups in length and pressure of the LES without changes in its ability to relax in response to swallowing. Considering the intra operative mishaps, we had nothing considerable in any of the two groups. The overall operative times were less in laparoscopic anti-reflux surgery. There was also an overall larger estimated blood loss in the open technique. The most striking difference was the much higher number of postoperative complications in open fundoplication. Complications related to the incision were the most frequent. In our institution; the laparoscopic procedure could be performed with about 20% less cost to the patient. |