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 21 February 2018

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News

Most patients pleased with laparoscopic antireflux surgery

Although almost one in three patients who have had surgery for gastrointestinal reflux disease report typical reflux symptoms years after the procedure, 90% describe their surgery as working well, according to an article in the April issue of the Archives of Surgery.

News image

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Jean Y. Liu, from the Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, USA, and colleagues surveyed 197 adults, 1 to 5 years after undergoing laparoscopic fundoplication for gastroesophageal reflux disease (GERD), to assess surgical outcome.

"Almost one third of the patients who underwent laparoscopic antireflux surgery at our institution in the past 1 to 5 years report at least some ongoing reflux symptoms," the researchers write.

However, only 5% were bothered "a lot" or "terribly" by the symptoms, which predominately include heartburn and regurgitation.

Symptoms attributable to either GERD or the adverse effects of surgery, such as bloating and dysphagia, were reported by 65% of the subjects.

Only 19% of patients responded that they were bothered "a lot" or "terribly".

Almost half take action to control these symptoms: 44% avoid certain foods, 41% have made lifestyle changes, and 14% take antireflux medicines daily.

Only 14% of patients take daily antireflux medication after laparoscopic surgery.
Archives of Surgery

"Nevertheless, few patients find either their symptoms or their treatments to be bothersome, and almost all (90%) are satisfied with their surgical results.

"Only 14% of patients continue to take daily antireflux medications (over-the-counter and prescription) after laparoscopic surgery, considerably lower than the 62% reported in a recent trial of long-term outcomes after open surgery," report the researchers.

The median time that elapsed since the subjects underwent laparoscopic surgery was 2.6 years.

The subjects' mean age was 51 years, and 52% of the respondents were men.

"Patients undergoing laparoscopic antireflux surgery should not expect their surgery to be curative - many will continue to experience some gastrointestinal symptoms or need to take some action to control these symptoms.

"Most patients, however, will experience significant improvement in their heartburn and regurgitation symptoms.

"As medical and surgical therapy have improved considerably during the past decade, new clinical trials assessing current therapies are needed to further inform clinical decision making," conclude the researchers.

Arch Surg 2002; 137: 397-401
15 April 2002

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