Symptoms and antireflux medication use following laparoscopic Nissen fundoplication: outcome at 1 and 4 years.
BACKGROUND
We have reported 1-year outcomes and antacid medication use in 100 patients undergoing laparoscropic Nissen fundoplication. As a follow-up study, we queried these same patients to determine whether their outcomes endured 4 years after fundoplication.


METHODS
One hundred patients undergoing laparoscopic Nissen fundoplication between 1992 and 1997 were asked, at 1 to 2 years and 4 to 6 years postoperatively, to grade their symptoms on a scale of 1 (mild) to 10 (severe). Patients were also queried as to the number/cost of antacid medications used before and after fundoplication.


RESULTS
Significant improvements were noted in symptoms of heartburn, postprandial emesis, gas/bloating, and dysphagia after fundoplication. Significant decreases in antacid medication use (97% vs 19%) and monthly costs (dollar 168 +/- dollar 91 vs dollar 30 +/- 54) were seen following fundoplication. The number of patients on antacid medications and the monthly costs of these medications (37% and dollar 53 +/- dollar 87, respectively) increased significantly from early to late follow-up, but were still significantly lower than those before surgery. Overall, 87% and 900% of patients were pleased with their outcome at early and late follow-up, respectively, and 93% and 92% of patients stated they would consider undergoing fundoplication again if necessary (P = NS).


CONCLUSIONS
Laparoscopic Nissen fundoplication results in a significant reduction in the symptoms of reflux and the use of antacid medications with a high degree of patient satisfaction. Although some patients return to antacid medications at late follow-up, they continue to have few symptoms and are pleased with their outcomes.
Bloomston
Mark
M
Department of Surgery, University of South Florida, College of Medicine, Tampa, Florida, USA.
Nields
William
W
Rosemurgy
Alexander S
AS
D000293:Adolescent; D000328:Adult; D000863:Antacids / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000601:surgery*; D049671:History, 18th Century; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000188:drug therapy; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000863:Antacids