title: Long-term satisfaction and medication dependence after antireflux surgery.
abstract: BACKGROUND
  Antireflux surgery remains an important treatment for gastroesophageal reflux disease (GERD) refractory to medical management. However, there is a paucity of data on long-term surgical outcomes. The objectives of this study were to determine long-term patient satisfaction and medication dependence after antireflux surgery.
  
  
  METHODS
  We identified all patients having antireflux surgery for GERD at our institution between 2000 and 2010. Medical records were reviewed and long-term outcomes were assessed using telephone surveys. Cox proportional hazards models were used to identify significant predictors of patient satisfaction and medication use 5 years and 10 years after surgery.
  
  
  RESULTS
  We surveyed 195 patients receiving antireflux surgery with a median follow-up of 6.3 years; 191 of 195 operations (98%) were performed laparoscopically. Five years after surgery, 82% of patients were satisfied with their operation and 83% of patients were not taking any antireflux medication. At 10 years postoperatively, these rates drop to 59% and 38%, respectively. Of patients taking medication who received formal evaluation of their symptoms, only 38.5% (15 of 39) had evidence of reflux. Age, sex, year of operation, surgeon specialty, body mass index, and presenting symptom were not associated with long-term satisfaction or medication use.
  
  
  CONCLUSIONS
  Antireflux surgery dramatically improves symptoms and provides excellent 5-year patient satisfaction and freedom from medication use. However, both of these outcomes decrease with follow-up out to 10 years.
authors.affiliation: Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Yinin
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Brian
authors.initials: B
authors.lastname: Ezekian
authors.affiliation: Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Kristen M
authors.initials: KM
authors.lastname: Wells
authors.affiliation: Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Burks
authors.affiliation: Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: David R
authors.initials: DR
authors.lastname: Jones
authors.affiliation: Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Lau
authors.affiliation: Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Schirmer
authors.affiliation: Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia; Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, Virginia. Electronic address: bdk8g@hscmail.mcc.virginia.edu.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Kozower
mesh_terms: D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: 8