Quality of life and gastric acid‐suppression medication 20 years after laparoscopic fundoplication

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.

Laparoscopic fundoplication performed in community hospital settings: A protocol for systematic review

“…[20,21] Campenello et al (2019) found that 84% of patients would recommend the procedure with data collected 20 years postoperatively. [22] A component of LF that is difficult to conceptualize is how patient selection affects outcomes. Although we were not able to fully develop a framework for how patient selection influenced outcomes across our review, a stringent patient selection process was highlighted by Hwang (2012).…”

“…For example, Dassinger et al (2004) reported that 12% of patients experienced post-operative reflux. [ 20 ] Long-term studies in tertiary centers such as Robinson et al (2014) and Campanello et al (2019) found rates of post-operative reflux of 19.6% and 26% respectively with patients followed-up for up to 20 years following LF [ 21 , 22 ]…”

Randomized controlled trial of robotic-assisted versus conventional laparoscopic fundoplication: 12 years follow-up

“…In addition to questionnaires on general QOL, disease-specific instruments are used to measure those areas of QOL that are specific to a particular disease. The longest follow-up series for QOL after CLF are currently limited to 20 years [16,19,32,33]. Moreover, there is a lack of comparable long-term follow-up data in the literature regarding RALF.…”

“…1). In the very heterogeneous literature, a mean long-term follow-up of at least 10 years [15][16][17][18][19] and moreover is reported and defined for the assessment of quality of life in GERD, so it seemed reasonable and feasible to us, and we decided on a 12-year follow-up for organizational reasons. Patients were sent a standardized questionnaire and were offered a follow-up visit at the outpatient clinic or an assessment via telephone call.…”

Langzeitverlauf nach chirurgischer Therapie der gastroösophagealen Refluxkrankheit

“…60 % der Patienten, 24 % der Patienten haben immer noch Schwierigkeiten mit Ruktation, die Dysphagierate ist hingegen mit 3-6 % sehr nieder. Dabei sind 87 % der operierten Patienten auch nach 20 Jahren mit dem Ergebnis zufrieden und 84 % der Patienten würden den Eingriff weiterempfehlen [37].…”