Laparoscopic antireflux surgery: long-term outcomes and quality of life

J Laparoendosc Adv Surg Tech A. 2006 Dec;16(6):557-61. doi: 10.1089/lap.2006.16.557.

Abstract

Background: To evaluate the outcome of antireflux surgery, we assessed disease-specific symptoms and quality of life of all patients treated by laparoscopic fundoplication at our center between 1992 and 2002.

Materials and methods: Preoperative symptoms and details of surgery were evaluated for 186 laparoscopic fundoplications. Disease-specific symptoms and quality of life were assessed using a questionnaire. Of 186 patients, 143 returned the questionnaire.

Results: The most common preoperative symptoms under medical antireflux therapy were regurgitation (54%) and heartburn (30%). Indications for surgery were refractory symptoms (88%) and the patient denying long-term medication (42%). The surgical approaches were Nissen fundoplication (98%) or Toupet fundoplication (2%, for heavy esophageal motility disorder). The conversion rate was 10%. There were no deaths, and 6 patients (3%) had to be reoperated. The questionnaire revealed that in 82% of the patients who responded, the preoperative reflux symptoms were gone, and 94% were satisfied with the result and would undergo surgery again. The average gastrointestinal quality of life index was 115 points (healthy volunteers in the literature, 120.8 points).

Conclusion: Laparoscopic fundoplication is a safe antireflux therapy resulting in high levels of patient satisfaction and near-normal quality of life in the long term.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Fundoplication*
  • Gastroesophageal Reflux / complications
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Quality of Life*
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome