Both medical therapy and laparoscopic antireflux surgery have been shown to improve quality of life in gastro-esophageal reflux disease (GERD).
Patients with poor symptom control or side effects on medical therapy might be expected to have improved quality of life after surgery.
|Preoperative scores while on medical therapy were improved after surgery|
|European Journal of Gastroenterology & Hepatology|
Dr Richard Gillies and colleagues determined whether patients whose symptoms are well controlled on medical therapy but who decide to undergo surgery would experience improved quality of life.
The team conducted a retrospective analysis of patient database between 1998 and 2003.
The researchers identified 60 patients who underwent laparoscopic antireflux surgery for the indication of patient preference.
The team used 2 generic quality-of-life questionnaires, including the Short Form 36, and Psychological General Well-Being index.
The researchers also used the Gastrointestinal Symptom Rating Scale, a gastrointestinal symptom questionnaire.
The questionnaires were used preoperatively, while the patients were on medical therapy, and 6 months after surgery.
The team reported that 38 patients completed all 3 questionnaires at both time intervals.
There were 31 males, and 7 females with a mean age of 42 years.
Preoperative scores while on medical therapy were significantly improved after surgery.
Short Form 36 median physical composite scores were 52 pre-surgery, and 54 after surgery.
The Short Form 36 mental composite scores were 51 with medical therapy, and 56 after surgery.
The team found that the psychological General Well-Being median total scores improved from 78 to 90 after surgery.
After surgery, the Gastrointestinal Symptom Rating Scale median total scores improved from 2 to 1.7.
The researchers observed another improvement in the reflux scores, from 2.5 to 1 after surgery.
Dr Gillies‘ team concluded, "Laparoscopic antireflux surgery significantly improved quality of life in reflux patients whose symptoms were well controlled on medical therapy."
"However, on the basis of a noncomparative trial with a relatively short follow-up period, we believe such patients should be considered for laparoscopic antireflux surgery."