A poor response to proton pump inhibition is not a contraindication for laparoscopic antireflux surgery for gastro esophageal reflux disease.
BACKGROUND
We aimed to determine if a poor response to proton pump inhibitors (PPIs) can predict a poor outcome following laparoscopic antireflux surgery (LARS) in our surgically treated population.


METHODS
A total of 324 patients undergoing LARS were included in this study. Following standardized assessment, patients recorded the efficacy of their medication on visual analogue scales. Pre- and postoperative symptom scores were recorded, with outcomes measured by modified Visick scores.


RESULTS
There were 233 good responders (>50% relief) and 91 poor responders (<49% relief). Both groups demonstrated a significant decline in postoperative symptom scores. Ninety-four percent of good responders had an excellent or good outcome, compared to 87% of poor responders. Twenty-seven patients reported a fair or poor outcome, despite improved postoperative symptom scores. Fifteen of these patients reported continuing heartburn; five had positive pH tests.


CONCLUSIONS
Our results do not support the assumption that a poor response to PPIs equates to a poor outcome after LARS.
Wilkerson
P M
PM
Department of Laparoscopic and Upper GI Surgery, Royal Berkshire Hospital, London Road, Reading RG1 5AN, England, UK. PMWilkerson@aol.com
Stratford
J
J
Jones
L
L
Sohanpal
J
J
Booth
M I
MI
Dehn
T C B
TC
D000328:Adult; D000075202:Contraindications; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors
D054328:Proton Pump Inhibitors