A randomized controlled trial of laparoscopic nissen fundoplication versus proton pump inhibitors for treatment of patients with chronic gastroesophageal reflux disease: One-year follow-up.
A randomized controlled trial conducted in patients with gastroesophageal reflux disease compared optimized medical therapy using proton pump inhibitor (n = 52) with laparoscopic Nissen fundoplication (n = 52). Patients were monitored for 1 year. The primary end point was frequency of gastroesophageal reflux dis-ease symptoms. Surgical patients had improved symptoms, pH control, and overall quality of life health index after surgery at 1 year compared with the medical group. The overall gastroesophageal reflux disease symptom score at 1 year was unchanged in the medical patients, but improved in the surgical patients. Fourteen patients in the medical arm experienced symptom relapse requiring titration of the proton pump inhibitor dose, but 6 had satisfactory symptom remission. No surgical patients required additional treatment for symptom control. Patients controlled on long-term proton pump inhibitor therapy for chronic gastroesophageal reflux disease are excellent surgical candidates and should experience improved symptom control after surgery at 1 year.
Anvari
Mehran
M
Centre for Minimal Access Surgery, Department of Surgery, St Joseph's Healthcare, 50 Charlton Ave E, Hamilton, ON, L8N 4A6 Canada. anvari@mcmaster.ca
Allen
Christopher
C
Marshall
John
J
Armstrong
David
D
Goeree
Ron
R
Ungar
Wendy
W
Goldsmith
Charles
C
D000328:Adult; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D054328:Proton Pump Inhibitors; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome
D054328:Proton Pump Inhibitors