title: Obesity does not affect the outcome of laparoscopic antireflux surgery.
abstract: BACKGROUND
  Obesity has been reported to adversely affect the outcome of laparoscopic antireflux surgery (LARS). This study examined pre- and postoperative clinical and objective outcomes and quality of life in obese and normal-weight patients following LARS at a specialized centre.
  
  
  METHODS
  Prospective data from patients subjected to LARS (Nissen or Toupet fundoplication) for symptomatic gastroesophageal reflux disease in the General Public Hospital of Zell am See were analyzed. Patients were divided in two groups: normal weight [body mass index (BMI) 20-25 kg/m(2)] and obese (BMI ≥ 30 kg/m(2)). Gastrointestinal quality of life index (GIQLI), symptom grading, esophageal manometry and multichannel intraluminal impedance monitoring data were documented and compared preoperatively and at 1 year postoperatively.
  
  
  RESULTS
  The study cohort included forty normal-weight and forty obese patients. Mean follow-up was 14.7 ± 2.4 months. The mean GIQLI improved significantly after surgery in both groups (p < 0.001, for both). Clinical outcomes improved following surgery regardless of BMI. There were significant improvements of typical and atypical reflux symptoms in normal weight and obese (p = 0.007; p = 0.006, respectively), but no difference in gas bloat and bowel dysfunction symptoms could be found. No intra- or perioperative complications occurred. A total of six patients had to be reoperated (7.5 %), two (5 %) in the obese group and four (10 %) in the normal-weight group, because of recurrent hiatal hernia and slipping of the wrap or persistent dysphagia due to closure of the wrap.
  
  
  CONCLUSIONS
  Obesity is not associated with a poorer clinical and objective outcome after LARS. Increased BMI seems not to be a risk factor for recurrent symptomatology and reoperation.
authors.affiliation: Department of General and Visceral Surgery, Sisters of Charity Hospital, Linz, Austria, ruzica-rosalia.luketina@bhs.at.
authors.forename: Ruzica-Rosalia
authors.initials: RR
authors.lastname: Luketina
authors.forename: Oliver Owen
authors.initials: OO
authors.lastname: Koch
authors.forename: Gernot
authors.initials: G
authors.lastname: Köhler
authors.forename: Stavros A
authors.initials: SA
authors.lastname: Antoniou
authors.forename: Klaus
authors.initials: K
authors.lastname: Emmanuel
authors.forename: Rudolph
authors.initials: R
authors.lastname: Pointner
mesh_terms: D015992:Body Mass Index; D005260:Female; D018662:Fundoplication / Q000379:methods*; D005764:Gastroesophageal Reflux / Q000150:complications / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011446:Prospective Studies; D011788:Quality of Life