#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

The Quality of Life Following Laparoscopic Fundoplication in Correlation with Preoperative Symptomatology


Authors: F. Marek;  V. Procházka;  Z. Kala;  Jiří Dolina 1;  T. Pavlík 2
Authors‘ workplace: Chirurgická klinika FN Brno-Bohunice a LF Masarykovy univerzity, přednosta: prof. MUDr. Z. Kala, CSc. ;  Interní gastroenterologická klinika FN Brno a LF Masarykovy univerzity Brno, přednosta: prof. MUDr. A. Hep, CSc. 1;  Institut biostatistiky a analýz, LF a PřF Masarykovy univerzity, vedoucí pracoviště: doc. RNDr. L. Dušek, Dr. 2
Published in: Rozhl. Chir., 2011, roč. 90, č. 3, s. 166-171.
Category: Monothematic special - Original

Overview

Aim:
Gastroesophageal reflux disorder (GERD) is a serious health problem in the Western world, with prevalence rates between 9 and 42%. The correct preoperative diagnostics including assessment of symptomatology is a prerequisite for the establishment of adequate therapy, including surgery. The aim of this study was to assess the quality of life in patients with GERD, based on their preoperative symptomatology.

Methods:
From IX/2004 to XII/2008, a total of 237 patients underwent antireflux procedures in the Brno Faculty Hospital (FN Brno) Surgical Clinic. The patients underwent preoperative and postoperative gastroenterological examination, including endoscopy, manometry, pH-metry. The patients were asked to fill in the GIQLI (GastroIntestinal Quality of Life Index) questionnaire. The results were statistically assessed and evaluated.

Results:
The study included a total of 178 patients. 135 subjects (76.7%) presenting with typical symptomatology and 41 subjects (23.3%) with atypical symptomatology were indicated for surgery. The mean preoperative quality of life index, based on the GIQLI questionnaire, was 101.6 points, while at 6 months after the procedure, the quality of life was evaluated with 106.9 points. There is a statistically significant difference in the quality of life between the patients with atypical and the patients with typical symptomatology, both prior to the procedure (p = 0.002), as well as after the procedure (p = 0.006), with the atypicaly symptomatology patients declairing poorer quality of life than the typical symptomatology ones. The risk of prolonged dysphagia (over 6 weeks after the procedure) is higher in the atypical symptomatology subjects, with statistical significance of p < 0.001.

Conclusion:
Laparoscopic antireflux surgery increases the quality of life independent of the preoperative symptomatology. Patients with atypical symptoms must be carefully examined and indicated with caution, considering the higher risk of prolonged postoperative dysphagia.

Key words:
quality of life – laparoscopy – reflux – symptoms


Sources

1. Delaney, B. C. Review article:prevalence and epidemiology of gastro-oesophageal reflux disease. Aliment Pharmacol. Ther., 2004; 20(suppl): 2–4.

2. Fujimoto, K. Review article:prevalence and epidemiology of gastro-oesophageal reflux disease in Japan. Aliment Pharmacol. Ther., 2004; 20: 5–8.

3. Tytgat, G. N. J., Janssens, J., Reynolds, J. C., Wienbeck, M. Update on the patophysiology and management of gastro-oesophageal reflux disease: the role of prokinetic therapy. Eur. J. Gastroenterol. Hepatol., 1966; 8: 603–611.

4. Parkman, H. P., Cohen, S. Heartburn, Regurgitation, Odyno­phagia, Chest pain, and Dysphagia. In: Bocus Gastroenterology. Haubrick SW., Schaffner F., Berk JE. WB Saunders Comp. Philadelphia, 1995; 30–40.

5. Lukáš, K., Mandys, V., Mareček, P., Hraboš, V., Hornig, A., Varnerová, Z., Šmejkalová, K., Aschermann, M. Srovnání výsledků endoskopického a histologického vyšetření u pacientů se symptomy refluxní choroby jícnu. Čes. a Slov. Gastroenterol., 2000; 54(4): 129–131.

6. Gaynor, E. B. Otolaryngologic manifestation of gastroesophageal reflux. Amer. J. Gastroenterol., 1991; 86: 801–808.

7. Sonntag, S. J., Schnell, T. G., Miller, T. Q., et al. Rolling review: Gastroesophageal reflux disease. Aliment Pharmacol. Ther., 1993; 7: 293–312.

8. Lukáš, K. Refluxní choroba jícnu. Karolinum, 2003.

9. Orlando, R. C. Reflux esophagitis. In: Textbook of gastroenterology. Yamada T. Lippincot, Baltimore, 1991; 1123–1147.

10. Stein, H. J., Feussner, H., Siewert, J. R. Surgical therapy of gastroesophageal reflux disease:which patient, which procedure, which approach? Dis. Esoph., 1994; 7: 239–244.

11. Eypasch, E., Williams, J. I., Wood Dauphine, S., Ure, B. M. Schmulling, C., Neugebauer, E. Gastrointestinal Quality Of Life Index:developement, validation and application of a new instrument. Br. J. Surg., 1995; 82: 216–222.

12. DeVault, K. R. Overview of medical therapy for gastroesophageal reflux disease. Gastroenterol. Clin. N. Am., 1999; 28: 831–845.

13. Revicki, D. A., Wood, M., Maton, P. N., Sorensen, S. The impact of gastroesophageal reflux disease on health-related quality of life. Am. J. Med., 1998; 104: 252–258.

14. Pope, C. E. The quality of life following antireflux surgery. World J. Surg., 1992; 16: 355–359.

15. Drahoňovský, V., Vrbenský, L., Kmeť, L., Pecák, P. Laparoskopická antirefluxní operace dle Nissen-Rossettiho – výsldky u 100 operovaných po 2 a 5 letech ve srovnání s předoperačním stavem. Čes. a Slov. Gastroenterol. a Hepatol., 2006; 60 (1): 17–25.

16. Mobius, C., Stein, H. J., Feith, M., et al. Quality of life before and after laparoscopic Nissen fundoplication. Surg. Endosc., 2001; 15: 353–356.

17. Stein, H. J., DeMeester, T. R., Hinder, R. A. Surgical therapy of gastroesophageal reflux disease: which patient, which procedure, which approach? Dis. Esoph., 1994; 7: 239–244.

18. Watson, D. I., Jamieson, G. G. Antoreflux surgery in laparoscopic era. Br. J. Surg., 1998; 85: 1173–1184.

19. Duffy, J. P., Maggard, M., Hiyama, D. T., Atkonson, J. B. Laparoscopic Nissen Fundoplication improves quality of lofe in patients with atypical symptoms of gastresophageal reflux. Am. Surg., 2003; 69: 833–838.

20. Jackson, P. G., Gleiber, M. A., Askari, R., Evans, S. R. T. Predictors of outcome in 100 consecutive laparoscopic antireflux procedures. Am. J. Surg., 2001; 181: 231–235.

21. Farrel, T. M., Richardson, W. S., Trus, T. L., Smith, C. D., Hunter, J. G. Response of atypical symptoms of gastroesophageal reflux surgery. Br. J. Surg., 2001; 88: 1649–1652.

22. Procházka, V. Dysfagie a dysmotilita v antirefluxní chirurgii, disertační práce. Brno, 2006.

23. Kala, Z., et al. Refluxní choroba jícnu – diagnostika a chirurgická léčba. Praha, Grada, 2003.

Labels
Surgery Orthopaedics Trauma surgery
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#