Anti-reflux procedure improved quality of life, cut need for 2nd treatment
FRIDAY, May 23 (HealthDay News) -- High levels of patient satisfaction and low rates of re-surgery were found in patients with gastroesophageal reflux disease (GERD) who had minimally invasive laparoscopic fundoplication (anti-reflux surgery) performed by an experienced surgeon, says a U.S. study.
Studies have shown the short-term effectiveness of laparoscopic anti-reflux surgery, but the results of longer-term studies have been varied, according to background information in the study by researchers at Massachusetts General Hospital and Harvard Medical School.
The study included 191 patients, average age 52, who had primary (173 patients) or revision (18 patients) laparoscopic anti-reflux surgery by the same surgeon between 1997 and 2006.
After the procedure, the patients provided information about their quality of life, use of anti-reflux medication, the need for postoperative intervention, satisfaction, and willingness to have the operation again. The median duration of follow-up was five years.
The study found that 71 percent of patients who had primary anti-reflux surgery were satisfied with their long-term results, compared with 35 percent of patients who had revision anti-reflux surgery. But the majority of patients in both groups (88 percent who had primary surgery and 76 who had redo surgery) said they'd be willing to have the surgery again.
"Only three patients (1.2 percent) required re-operation," the study authors wrote. "Patients with body-mass indexes (BMIs) between 25 and 35 had lower GERD-HRQL (health-related quality of life) scores than thin and morbidly obese patients."
The findings were published in the May issue of the Archives of Surgery.
"In contrast to reports in the medical literature, the results of this study demonstrate that most patients undergoing primary laparoscopic fundoplication by an experienced surgical team have near normal GERD-HRQL scores at long-term follow-up and low re-operation rates and are satisfied with their decision to undergo surgery. In addition, BMI appears to be an important factor when predicting long-term outcomes," the study authors concluded.
"Results following redo laparoscopic fundoplication are not as good, highlighting the importance of proper patient selection and surgical technique when performing primary laparoscopic fundoplication."
The American College of Gastroenterology has more about GERD.
-- Robert Preidt
SOURCE: JAMA/Archives journals, news release, May 19, 2008
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