Abstracts
2000 Digestive Disease Week

# 2260 Morbid Obesity Does NOT Predict a Poor Outcome After Laparoscopic Antireflux Surgery.
Stephen S. McNatt, C. Daniel Smith, John G. Hunter, Kathy G. Galloway, Atlanta, GA

Morbid Obesity (MO) has been regarded as a relative contraindication to laparoscopic antireflux surgery (LARS) due to intraoperative technical difficulties and a potentially higher failure rate. We reviewed our experience with LARS in the morbidly obese. From a prospectively collected database of over 1000 patients undergoing LARS between 10/91 and 10/99, 37 patients with a body mass index (BMI) >35 were identified. This group was compared to an age and sex-matched cohort with a BMI of 17-27 (NL) undergoing LARS during the same period. Operative time (ORT)*, length of stay (LOS)*, ASA class†, postoperative antireflux medication use? (POM), reoperation rate‡ (ROR), and operative complications‡ (OC) were compared. Symptom scores† for heartburn (HB), dysphagia (DYS), and regurgitation (REG) were compared at 6 weeks and one year postoperatively, and final follow-up. Follow-up was by survey and physician visit. (*Student’s t-test, †Wilcoxon Signed Ranks Test, ??2 Test, ‡Fisher’s Exact Test). RESULTS: When compared to preop scores, symptom scores for HB and REG improved significantly in both groups at all postop times. DYS did not significantly change postoperatively; however, few patients reported significant preop DYS. Symptom scores did not differ between the two groups except for more DYS at 6 weeks in the NL group and more REG at final follow-up in the MO group. LARS in the morbidly obese results in outcomes similar to those of non-obese patients. This suggests that MO should not be a contraindication to LARS.