Quality of life following laparoscopic Nissen fundoplication: Assessing short-term and long-term outcomes

Kellokumpu, Ilmo; Voutilainen, Markku; Haglund, Caj; Färkkilä, Martti; Roberts, Peter; Kautiainen, Hannu

doi:10.3748/wjg.v19.i24.3810

Cited by 65 publications

(41 citation statements)

References 29 publications

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“…The mean preoperative quality of life score was 32.34 6 4.28 (22-38); postoperatively, the average value of this score decreased to 4.76 6 0.92 (3)(4)(5)(6). In the postoperative period, GERD-HRQL scores were significantly decreased compared to the preoperative period (P ¼ 0.001).…”

Section: Resultsmentioning

confidence: 77%

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Laparoscopic Nissen Fundoplication: Analysis of 162 Patients

Sari

Gönüllü

Tiryaki

et al. 2016

International Surgery

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We aimed to evaluate the frequency of the need for proton pump inhibitor treatment following laparoscopic Nissen fundoplication (LNF) for gastroesophageal reflux disease (GERD). A total of 162 patients with GERD were treated surgically with LNF from October 2006 to March 2010 in our surgery department. Diagnoses were made by using upper gastrointestinal system (GIS) endoscopy and 24-hour pH monitoring, and all the patients underwent routine LNF surgery. The patients were questioned regarding complaints and proton pump inhibitor (PPI) usage during the postoperative period, and 40 patients who had postoperative GIS symptoms were included. Upper GIS endoscopy with antral biopsy for Helicobacter pylori (HP) identification and multichannel intraluminal impedance pH (MII-pH) monitoring were applied, and all the data were evaluated. The median postoperative follow-up time was 1.84 6 0.850 (0.29-3.48) years. PPI treatment frequency was 37.5% (15 patients) in the 40 symptomatic patients, or 9.26% in all 162 patients who were operated on. The reason for PPI usage in 3 patients (7.5%) was regarded as recurrence. HP positivity was 67.5% in the symptomatic patients and 73.3% in the PPI treated group; 40% (6 patients) recovery was achieved in the HP (þ) patients by using an HP eradication treatment protocol. The operated patients displayed statistically significant results in increased quality of life (P ¼ 0.001) and lowered DeMeester scores (P ¼ 0.000) during the postoperative period when compared with the

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Section: Resultsmentioning

confidence: 77%

“…3 However, after surgery, gastrointestinal side effects, such as bloating, diarrhea, burping, abdominal pain, and flatus may occur. 4 The present study was performed to investigate the frequency and reasons for continuing proton pump inhibitor (PPI) use during the postoperative period in patients undergoing LNF.…”

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confidence: 99%

Laparoscopic Nissen Fundoplication: Analysis of 162 Patients

Sari

Gönüllü

Tiryaki

et al. 2016

International Surgery

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“…In 10 years of postoperative follow-up, excellent symptomatic results were obtained with the rate of 90% to 95%. [4,5] …”

Section: Introductionmentioning

confidence: 99%

Laparoscopic revision surgery for gastroesophageal reflux disease

Celasin

Genç²,

Çelik³

et al. 2017

Medicine

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Laparoscopic antireflux surgery is a frequently performed procedure for the treatment of gastroesophageal reflux in surgical clinics. Reflux can recur in between 3% and 30% of patients on whom antireflux surgery has been performed, and so revision surgery can be required due to recurrent symptoms or dysphagia in approximately 3% to 6% of the patients. The objective of this study is to evaluate the mechanism of recurrences after antireflux surgery and to share our results after revision surgery in recurrent cases.From 2001 to 2014, revision surgery was performed on 43 patients (31 men, 12 women) between the ages of 24 and 70 years. The technical details of the first operation, recurrence symptoms, endoscopy, and manometry findings were evaluated. The findings of revision surgery, surgical techniques, morbidity rates, length of hospitalization, and follow-up period were also recorded and evaluated.The first operation was Nissen fundoplication in 34 patients and Toupet fundoplication in 9 patients. Mesh hiatoplasty was performed for enforcement in 18 (41.9%) of these patients. The period between the first operation and the revision surgery ranged from 4 days to 60 months. The most common finding was slipped fundoplication and presence of hiatal hernia during revision surgery. Revision fundoplication and hernia repair with mesh reinforcement were used in 33 patients. The other techniques were Collis gastroplasty, revision fundoplication, and hernia repair without mesh. The range of follow-up period was from 2 to 134 months. Recurrence occurred in 3 patients after revision surgery (6.9%). Although revision surgery is difficult and it has higher morbidity, it can be performed effectively and safely in experienced centers.

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“…The classification used for endoscopic assessment of esophagitis was Los Angeles classification 20 .…”

Section: Preoperative Endoscopic Evaluationmentioning

confidence: 99%

“…L aparoscopic fundoplication is the definitive treatment for gastroesophageal reflux disease (GERD) with safe and good results in long-term follow 9,20,22,29,37 . However, potential side effects include dysphagia, gasbloat and the inability to vomit.…”

Section: Introductionmentioning

confidence: 99%

Identificação de fatores de risco pré-operatórios para disfagia pós-operatória persistente após cirurgia laparoscópica para doença do refluxo gastroesofágico

Ribeiro

Tercioti-Júnior

Souza-Neto

et al. 2013

ABCD, arq. bras. cir. dig.

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-Background:Postoperative dysphagia is common after antireflux surgery and generally runs a self-limiting course. Nevertheless, part of these patients report long-term dysphagia. Inadequate surgical technique is a well documented cause of this result. Aim: This retrospective study evaluated the preoperative risk factors not surgery-related for persistent dysphagia after primary laparoscopic antireflux surgery. Methods: Patients who underwent laparoscopic antireflux surgery by the modified technique of Nissen were evaluated in the preoperative period retrospectively. Postoperative severity of dysphagia was evaluated prospectively using a stantardized scale. Dysphagia after six weeks were defined as persistent. Statistical tests of association and logistic regression were used to identify risk factors associated with persistent dysphagia. Results: A total of 55 patients underwent primary antireflux surgery by a single surgeon team. Of these, 25 patients had preoperative dysphagia (45,45%). Persistent postoperaive dysphagia was reported by 20 (36,36%). Ten patients (18,18%) required postoperative endoscopic dilatation for dysphagia. There was statistical association between satisfaction with surgery and postoperative dysphagia and requiring the use of antireflux medication after the procedure; and between preoperative dysphagia and postoperative dysphagia. Logistic regression identified significant preopertive dysphagia as risk factor for persistent postoperative dysphagia. No correlations were found with preoperative manometry. Conclusions: Patients with significant preoperative dysphagia were more likely to report persistent postoperative dysphagia. This study confirms that the current manometric criteria used to define esophageal dysmotility are not reliable to identify patients at risk for post-fundoplication dysphagia. Minucious review of the clinical history about the presence and intensity of preoperative dysphagia is important in the selection of candidates for antireflux surgery. RESUMO -Racional:Disfagia no pós-operatório é comum após a operação anti-refluxo. No entanto, uma parte dos pacientes relatam disfagia persistente, e técnica cirúrgica inadequada é uma causa bem documentada deste resultado. Objetivo: Este estudo retrospectivo avaliou os fatores de risco no pré-operatório para a disfagia persistente após operação antirefluxo por via laparoscópica. Métodos: Pacientes submetidos à operação anti-refluxo por via laparoscópica pela técnica de Nissen modificada foram avaliados no pré-operatório de forma retrospectiva. A severidade da disfagia pós-operatória foi avaliada prospectivamente usando uma escala estabelecida. A disfagia após seis semanas foi definida como persistente. Os testes estatísticos de associação e regressão logística foram utilizados para identificar os fatores de risco associados à disfagia persistente. Resultados: Um total de 55 pacientes foram submetidos ao procedimento por via laparoscópica por uma única equipe de cirurgiões. Destes, 25 doentes referiam disfagia pré-operató...

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Quality of life following laparoscopic Nissen fundoplication: Assessing short-term and long-term outcomes

Abstract: For the long-term, our results indicate decreasing effectiveness of laparoscopic antireflux surgery, although most of the patients seem to have an overall quality of life similar to that of the general population.

Cited by 65 publications

References 29 publications

Laparoscopic Nissen Fundoplication: Analysis of 162 Patients

Laparoscopic Nissen Fundoplication: Analysis of 162 Patients

Laparoscopic revision surgery for gastroesophageal reflux disease

Identificação de fatores de risco pré-operatórios para disfagia pós-operatória persistente após cirurgia laparoscópica para doença do refluxo gastroesofágico

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