Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 20 November 2017

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Quality of life is superior after antireflux surgery for GERD compared with medical care

Heartburn scores and global Quality of Life scores are superior after laparoscopic fundoplication compared with medical management, according to research published in the January 2002 issue of the Journal of the American College of Surgeons.

News image

fiogf49gjkf04

A team from Pittsburgh, Pennsylvania, USA, compared quality of life (QOL) after antireflux surgery with nonoperative management for severe gastroesophageal disease (GERD).

Some 171 patients undergoing surgical or medical treatment for GERD over a 1-year period were included in the retrospective analysis.

QOL was measured using the Short-Form 36, and heartburn severity was measured using the Health Related Quality of Life scale (a disease-specific instrument with a best score of 0 and a worst score of 45).

Laparoscopic fundoplication was undertaken in 120 patients with a median age of 47 years (range 17 to 80 years).

The medical cohort included 51 patients selected from the gastroenterology clinic with a median age of 48 years (range 17 to 82 years).

Duration of heartburn was not found to be significantly different, with 78% of the medical and 82% of the surgical patients having had symptoms for longer than 12 months.

There were no operative deaths. However, there were 12 complications (1 esophageal perforation, 2 pneumothorax, 1 pneumonia, 3 pulmonary embolus, 5 other).

Mean length of stay was 1.6 days, time to oral intake 1.2 days, and return to normal activity 4.2 weeks.

QOL and satisfaction greater in the surgery group.
Journal of the American College of Surgeons

Routine follow-up was available in 118 surgical and 47 medical patients.

The researchers found that the medical cohort had increased symptoms of heartburn (43% versus 19%), waterbrash (26% versus 8%), and regurgitation (30% versus 8%) over the surgical group. Furthermore, they had greater requirement for proton pump inhibitors (74% versus 19%) and propulsid (19% versus 3%).

Detailed outcomes were available in 101 surgical and 37 medical patients.

Mean Health Related QOL scores were better in the surgical group (4 versus 21).

More of the medical patients were found to be dissatisfied (22% versus 6%).

Short-Form 36 scores at follow-up were better in 6 of 8 domains for surgical patients.

Hiran C. Fernando, of the Minimally Invasive Surgery Center at the University of Pittsburgh Medical Center, said on behalf of fellow authors, "Heartburn scores and global QOL scores were superior after laparoscopic fundoplication compared with medical management in this patient population.

"Laparoscopic fundoplication should be considered for patients who are dissatisfied with medical treatment," it was concluded.

J Am Coll Surg 2002; 194(1): 23-7
07 January 2002

Go to top of page Email this page Email this page to a colleague

 20 November 2017 
Barriers to hepatitis C treatment
 20 November 2017 
Socioeconomic characteristics in diverticular disease
 20 November 2017 
Endoscopic indices of disease activity for Crohn’s
 17 November 2017 
Food elimination diets for treatment of adults with eosinophilic esophagitis
 17 November 2017 
PPI use and cognitive function in women
 17 November 2017 
Predicting microscopic colitis
 16 November 2017 
NAFLD-hepatocellular carcinoma and survival after orthotopic liver transplant
 16 November 2017 
Prepregnancy obesity and severe maternal morbidity
 16 November 2017 
Celiac disease screening in adult first-degree relatives
 15 November 2017 
Breastfeeding and the risk of IBD
 15 November 2017 
Medication nonadherence and health care costs
 15 November 2017 
Predicting recurrence after curative rectal cancer surgery
 14 November 2017 
HBV/HCV coinfection and cirrhosis
 14 November 2017 
Sexual dysfunction after rectal cancer surgery
 14 November 2017 
Eosinophilic gastroenteritis and colitis
 13 November 2017 
GI bleeding in patients taking non–vitamin K antagonist oral anticoagulants
 13 November 2017 
Genetic polymorphisms, fatty acids and ulcerative colitis
 13 November 2017 
Flares after immunomodulator withdrawal in Crohn's
 10 November 2017 
Thiopurines vs TNF and lymphoma risk in IBD
 10 November 2017 
Drug monitoring of anti-tumour necrosis factor therapy in IBD
 10 November 2017 
Treatment decisions for older patients with colorectal cancer
 09 November 2017 
Quality standards in upper gastrointestinal endoscopy
 09 November 2017 
Irradiated rectal cancer and chemoradiotherapy
 09 November 2017 
Environmental factors and IBD
 08 November 2017 
Prophylaxis of spontaneous bacterial peritonitis
 08 November 2017 
Optimal management of postoperative Crohn's disease
 07 November 2017 
Community Screening for Helicobacter pylori
 07 November 2017 
Early readmission in IBD patients
 07 November 2017 
Mesocolic excision for colon cancer
 06 November 2017 
Food elimination diet for children with eosinophilic esophagitis
 06 November 2017 
Biologic agents and obesity in children with IBD
 06 November 2017 
Liver cancer burden despite extensive use of antiviral agents
 03 November 2017 
Statins and mortality in chronic viral hepatitis
 03 November 2017 
Propofol for outpatient colonoscopy
 03 November 2017 
Asthma and IBD development
 02 November 2017 
Diverticulitis and emergency department burden
 02 November 2017 
Rural residence and risk of IBD
 02 November 2017 
Sexual functioning in Hep C
 01 November 2017 
Heartburn relief in adolescents with GERD
 01 November 2017 
Autoimmune pancreatitis in children
 31 October 2017 
Follow-up of positive results on fecal blood tests
 31 October 2017 
Surveillance in ulcerative colitis and Crohn’s disease
 30 October 2017 
Local recurrence after curative rectal cancer surgery
 30 October 2017 
Low-flow ascites pump in refractory cirrhosis
 30 October 2017 
Medical therapy of patients with pediatric-onset IBD
 27 October 2017 
NAFLD in advanced fibrosis in the USA
 27 October 2017 
Early readmission in cirrhosis after bacterial infections
 26 October 2017 
Predicting response to anti-TNF therapy in Crohn's
 26 October 2017 
Conversion to open laparotomy in rectal cancer
 25 October 2017 
Conversion of colonoscopy to sigmoidoscopy
 25 October 2017 
Fecal microbiota transplantation
 25 October 2017 
Rifaximin and survival in hepatic encephalopathy
 24 October 2017 
Eosinophilic esophagitis with swallowed topical corticosteroids
 24 October 2017 
Meta-analysis in nutritiona research
 23 October 2017 
NAFLD-related hepatocellular carcinoma in liver resection
 23 October 2017 
Outcome of hepatic sarcoidosis
 20 October 2017 
Conversion of planned colonoscopy to sigmoidoscopy
 20 October 2017 
Hospital readmissions reduction program
 19 October 2017 
Surgical anastomosis at 1-year colorectal cancer surveillance
 19 October 2017 
Fecal immunochemical tests in colorectal cancer screening

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2017 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us