Quality of life for patients with gastroesophageal reflux disease 2 years after laparoscopic fundoplication. Evaluation of the results obtained during the initial experience.
BACKGROUND
Health-related quality of life (HRQL) is significantly affected by gastroesophageal reflux disease (GERD), and its evaluation is emerging as a factor important to select treatment options for GERD. Antireflux laparoscopic surgery improves HRQL. The aim of this study was to compare the preoperative and medium-term postoperative HRQL in patients submitted to laparoscopic fundoplication during the initial experience to verify its possible influence on HRQL outcomes.


METHODS
Clinical assessment, endoscopy, and a previously validated HRQL index were performed before and 2 years after surgery in 32 patients who underwent at the beginning of our experience.


RESULTS
The esophageal mucosa returned to normal 2 years after laparoscopic fundoplication in 81% of the patients. Heartburn was absent or occasional in 93%, and 65% were free of antisecretory drugs. All postoperative HRQL items were significantly improved (p <0.0001), with the postoperative curve of HRQL scores superposable to those of healthy Italian subjects (Italian normative sample).


CONCLUSIONS
The initial phase of learning does not affect the improvement of HRQL observed after laparoscopic antireflux surgery, which is consistent with durable relief of symptoms and endoscopic healing. Evaluation of HRQL should be added to, and probably could replace in most cases, the objective postoperative testing.
Contini
S
S
Department of General Surgery and Organ Transplantation, School of Medicine and Dentistry, University of Parma, Maggiore University Hospital, Via Gramsci 14, 43100 Parma, Italy. continis@unipr.it
Bertelé
A
A
Nervi
G
G
Zinicola
R
R
Scarpignato
C
C
D000328:Adult; D000368:Aged; D000863:Antacids / Q000627:therapeutic use; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000009:adverse effects / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006304:Health Status; D006356:Heartburn / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011300:Preoperative Care; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D000863:Antacids