No abstract

Background Laparoscopic fundoplication is an effective treatment for gastro‐oesophageal reflux disease (GERD). We aimed to assess quality of life (QoL), long‐term residual symptoms, patient satisfaction and use of acid‐suppression medication at 5, 10 and 20 years after surgery. Methods We identified a cohort of 100 patients who underwent laparoscopic fundoplication between 1993 and 1998. The validated QoL questionnaires Short Form health survey (SF‐36), and Quality‐of‐Life in Reflux and Dyspepsia (QOLRAD), as well as a specific questionnaire regarding post‐fundoplication symptoms, were sent to the patients at 5, 10 and 20 years after surgery. Furthermore, patients who reported using the acid‐suppression medication after 20 years were interviewed by telephone regarding their reason for taking it. Results Eighty‐eight percent of the patients responded at 5 and 10 years post‐surgery. Twenty years following fundoplication, 68 (84% of those still alive) patients completed the questionnaires. The patients had equivalent health‐related QoL scores in both the QOLRAD and SF‐36 questionnaires after 10 and 20 years, and those scores were in line with a Swedish age‐matched population. After 20 years, 87% were satisfied with the results, and 84% of the patients would recommend reflux surgery to a relative or a friend. At the telephone interview, 32% (22/68) confirmed using acid‐suppression medication, but only half (11/68) used it because of reflux symptoms. Conclusion The long‐term, satisfying outcomes in GERD symptoms and QoL 5 and 10 years after surgery were maintained at a 20‐year follow‐up. Half of the patients used acid‐suppression medication for reasons other than GERD symptoms.

Urinary diversion with a Kock reservoir or Bricker conduit did not cause bone demineralization of significant changes in different markers of bone metabolism in patients examined 2 to 17 years after urinary diversion.

The present results indicate that asymptomatic bacteriuria in patients with a continent ileal reservoir for urinary diversion is generally of no clinical importance and should not be treated with antibiotics. This conclusion is based on the observations that the bacterial strains growing in the reservoir changed spontaneously indicating colonization rather than infection. Raised titres of antibodies against E. coli correlated weakly with bacterial growth. The observed elevations in antibody titres were usually just above the normal upper limit.