Laparoscopic antireflux surgery for gastroesophageal reflux disease: A clinical analysis of 185 patients                         SHAN Cheng-xiang, ZHANG Wei, JIANG Dao-zhen, et al. Department of General Surgery, Chang Zheng Hospital Affiliated to Second Military Medical University, Shanghai 200003, China
Corresponding author: QIU Ming, E-mail: Qiuming2006@yahoo.cn
Abstract    Objective    To summarize the technical practice of laparoscopic antireflux surgery (LARS) for gastroesophageal reflux disease (GERD). Methods    The clinical data, high-definition LARS videos, and postoperative diet scheme of 185 GERD patients from 2000 to 2013 in Department of General Surgery, Chang Zheng Hospital Affiliated to Second Military Medical University were reviewed retrospectively. Results    Laparoscopic antireflux surgery (hiatal herniorrhaphy plus fundoplication) was all successfully performed in 185 patients with none death and conversion operation. The procedure of LARS was divided into 7 steps according to our experience and HD video, standard surgical rules were followed and specific anatomic landmarks were found in each step, such as diaphragmatic crura and esophageal hiatus. The patients were deprived of food 24 hours after surgery and recovered to normal diet from clear liquid gradually and slowly. Conclusion    Identification of anatomic landmarks and surgical planes, and adherence of technical key points are important to perform LARS successfully. Effective postoperative dietary guidance is helpful to increase satisfaction rate of patients.