title: Pre-operative clinical and instrumental factors as antireflux surgery outcome predictors.
abstract: Gastroesophageal reflux disease (GERD) is nowadays a highly prevalent, chronic condition, with 10% to 30% of Western populations affected by weekly symptoms. Many patients with mild reflux symptoms are treated adequately with lifestyle modifications, dietary changes, and low-dose proton pump inhibitors (PPIs). For those with refractory GERD poorly controlled with daily PPIs, numerous treatment options exist. Fundoplication is currently the most commonly performed antireflux operation for management of GERD. Outcomes described in current literature following laparoscopic fundoplication indicate that it is highly effective for treatment of GERD; early clinical studies demonstrate relief of symptoms in approximately 85%-90% of patients. However it is still unclear which factors, clinical or instrumental, are able to predict a good outcome after surgery. Virtually all demographic, esophagogastric junction anatomic conditions, as well as instrumental (such as presence of esophagitis at endoscopy, or motility patterns determined by esophageal high resolution manometry or reflux patterns determined by means of pH/impedance-pH monitoring) and clinical features (such as typical or atypical symptoms presence) of patients undergoing laparoscopic fundoplication for GERD can be factors associated with symptomatic relief. With this in mind, we sought to review studies that identified the factors that predict outcome after laparoscopic total fundoplication.
authors.affiliation: Salvatore Tolone, Giorgia Gualtieri, Giuseppina Casalino, Simona Parisi, Ludovico Docimo, Division of General and Bariatric Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tolone
authors.affiliation: Salvatore Tolone, Giorgia Gualtieri, Giuseppina Casalino, Simona Parisi, Ludovico Docimo, Division of General and Bariatric Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Gualtieri
authors.affiliation: Salvatore Tolone, Giorgia Gualtieri, Giuseppina Casalino, Simona Parisi, Ludovico Docimo, Division of General and Bariatric Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Savarino
authors.affiliation: Salvatore Tolone, Giorgia Gualtieri, Giuseppina Casalino, Simona Parisi, Ludovico Docimo, Division of General and Bariatric Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Marzio
authors.initials: M
authors.lastname: Frazzoni
authors.affiliation: Salvatore Tolone, Giorgia Gualtieri, Giuseppina Casalino, Simona Parisi, Ludovico Docimo, Division of General and Bariatric Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: de Bortoli
authors.affiliation: Salvatore Tolone, Giorgia Gualtieri, Giuseppina Casalino, Simona Parisi, Ludovico Docimo, Division of General and Bariatric Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Manuele
authors.initials: M
authors.lastname: Furnari
authors.affiliation: Salvatore Tolone, Giorgia Gualtieri, Giuseppina Casalino, Simona Parisi, Ludovico Docimo, Division of General and Bariatric Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Casalino
authors.affiliation: Salvatore Tolone, Giorgia Gualtieri, Giuseppina Casalino, Simona Parisi, Ludovico Docimo, Division of General and Bariatric Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Parisi
authors.affiliation: Salvatore Tolone, Giorgia Gualtieri, Giuseppina Casalino, Simona Parisi, Ludovico Docimo, Division of General and Bariatric Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Savarino
authors.affiliation: Salvatore Tolone, Giorgia Gualtieri, Giuseppina Casalino, Simona Parisi, Ludovico Docimo, Division of General and Bariatric Surgery, Second University of Naples, 80131 Naples, Italy.
authors.forename: Ludovico
authors.initials: L
authors.lastname: Docimo
keywords: Antireflux surgery; Fundoplication; Gastroesophageal reflux disease; High resolution manometry; Impedance-pH monitoring; Laparoscopy; Nissen; Outcome predictors