Immediate radiographic assessment following laparoscopic antireflux operations is unnecessary.
BACKGROUND
Laparoscopic antireflux operations (LAP) have become increasingly common for the treatment of gastroesophageal reflux disease (GERD). We sought to determine if routine postoperative barium contrast studies following LAP were clinically efficacious in identifying technical problems and life-threatening complications related to the surgical intervention.


METHODS
From January 1996 to December 1997, 112 barium studies were performed following 112 LAP procedures (47 male/65 female patients; mean age, 51 years) (group I). This group was compared to a subsequent cohort of 67 patients who underwent LAP between January 1998 and July 1998 without routine early postoperative barium contrast study (group II).


RESULTS
In 111/112 of the barium studies of group I, no radiographic abnormality was identified. The average length of stay (LOS) for these patients was 2.6 days. Routine barium studies were not utilized in group II. The average length of stay for patients in group II was 1.4 days. Twelve group II patients underwent early postoperative barium studies to evaluate suspicious clinical symptoms. None of these 12 postoperative studies identified important problems, nor did they alter the patients' clinical management. However, because of the barium study, their LOS was equivalent to those patients who had undergone routine barium study (2.4 days). There was an increase of $1451.80 in hospital charges in the group of patients who had a barium study, largely as a result of the increased LOS.


CONCLUSIONS
The routine use of these studies results in increased patient charges and a prolongation in the length of hospital stay. Immediate postoperative barium studies following laparoscopic antireflux operations are of little value in determining important postoperative problems among patients undergoing LAO.
Szwerc
M F
MF
Division of General Thoracic Surgery, Allegheny General Hospital, Medical College of Pennsylvania Hahnemann University, 320 East North Avenue, Level 02 South Tower, Pittsburgh, Pennsylvania 15212-4772, USA.
Gagne
D J
DJ
Wiechmann
R J
RJ
Maley
R H
RH
Santucci
T S
TS
Landreneau
R J
RJ
D001466:Barium Sulfate / Q000191:economics / Q000627:therapeutic use; D003287:Contrast Media / Q000191:economics / Q000627:therapeutic use; D005260:Female; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011859:Radiography / Q000191:economics
D003287:Contrast Media; D001466:Barium Sulfate