Clinical Outcomes and Quality of Life after Laparoscopic Nissen Fundoplication for Refractory Gastroesophageal Reflux Disease: A Prospective Cohort Study from Vietnam.

BACKGROUND/AIMS: Gastroesophageal reflux disease (GERD) significantly impairs quality of life. Although proton pump inhibitors are first-line therapy, a subset of patients remains refractory to medical treatment. Laparoscopic Nissen fundoplication (LNF) is considered the gold-standard surgical option; however, high-quality prospective outcome data from Southeast Asia, particularly Vietnam, remain limited. This study aimed to evaluate clinical outcomes and symptom control following LNF in patients with refractory GERD.

METHODS

This prospective cohort study included 61 consecutive patients with refractory GERD who underwent LNF at Can Tho General Hospital between March 2022 and September 2025. Gastroesophageal reflux disease questionnaire (GERD-Q) scores and symptom control were assessed at 1 month, 6 months, 12 months, and at the end of follow-up.

RESULTS

The mean age was 38.9±14.3 years, and 54.1% of patients were male. All procedures were completed laparoscopically, with a mean operative time of 102.3±17.4 minutes. Postoperative recovery was rapid, with early resumption of oral intake and ambulation. Postoperative complications occurred in 19.7% of patients and were limited to Clavien-Dindo grades I-II, with no mortality. GERD-Q scores decreased significantly from 14.26±1.69 preoperatively to 7.00±0.99 at 1 month and continued to decline during follow-up, reaching 5.41±1.18 at the end of the study (p<0.001). Good symptom control was maintained in 83.6-90.2% of patients across follow-up time points.

CONCLUSIONS

LNF is a safe and effective treatment for refractory GERD, providing rapid recovery and durable symptom control in appropriately selected patients.