The use of medication after laparoscopic antireflux surgery.
BACKGROUND
Laparoscopic antireflux surgery (LARS) significantly improves symptoms of gastro-esophageal reflux disease (GERD) and quality of life. Nevertheless, 14-62% of patients report using antisecretory medication after surgery, although only a tiny percentage has proven recurrence of GERD. We sought to determine symptoms of GERD, quality of life, and use of medication before and after LARS, and to compare our findings with those from previous studies.


METHODS
Five hundred fifty-three patients with GERD who underwent LARS were evaluated before and at 1 year after surgery. After surgery, multidisciplinary follow-up care was provided for all patients by surgeons, psychologists, dieticians, and speech therapists.


RESULTS
Symptoms of GERD and quality of life improved significantly and only 4.2% of patients still required medication after surgery [proton pump inhibitors (PPI) (98.4 vs. 2.2%; p < 0.01), prokinetics (9.6 vs. 1.1%; p < 0.01), and psychiatric medication (8 vs. 1.6%; p < 0.01)].


CONCLUSIONS
LARS significantly reduced medication use at 1-year follow-up. However, these effects might be attributed, in part, to the multidisciplinary follow-up care. Further studies are therefore required to investigate which patients may benefit from multidisciplinary follow-up care and whether its selective application may reduce the need for medication after LARS.
Ciovica
Ruxandra
R
Department of Surgery, General Hospital of Krems, Mitterweg 10, 3500, Krems, Austria.
Riedl
Otto
O
Neumayer
Christoph
C
Lechner
Wolfgang
W
Schwab
Gerhard P
GP
Gadenstätter
Michael
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication; D005764:Gastroesophageal Reflux / Q000188:drug therapy* / Q000601:surgery; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D011184:Postoperative Period; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D011788:Quality of Life; D012008:Recurrence; D055815:Young Adult
D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D005765:Gastrointestinal Agents; D054328:Proton Pump Inhibitors