Quality of Life, Symptomatic Outcome and Patients Satisfaction after Laparoscopic Refundoplication in GERD Patients with Failed Primary Antireflux Surgery: A 3 to 5 Years Follow-Up
Abstracts
|
Background: Quality of life and patients satisfaction has been shown to be an important issue to estimate outcome of laparoscopic antireflux surgery (LARS). Aim of this study was to evaluate quality of life data, patients satisfaction and change of symptoms in 27 patients who underwent laparoscopic redo-surgery after failed primary open or laparoscopic antireflux surgery 3 to 5 years after surgery. Methods and procedures: Between March 1995 and June 1998, 27 consecutive patients with a mean age of 57 years (range 35 to 78) underwent laparoscopic refundoplication for failed primary open or laparoscopic antireflux surgery. Quality of life was evaluated using the Gastrointestinal Quality of Life Index (GIQLI). Additionally, patients satisfaction and symptomatic outcome was evaluted using a standardized questionnaire. Results: Three to five years after laparoscopic refundoplication, patients quoted their quality of life (GIQLI) in an overall score of 113.4 points, which is comparable to that of patients who underwent primary laparoscopic antireflux surgery. 25 (92.6%) patients estimated their satisfaction with the redo-procedure as very good and would undergo surgery again if necessary. These patients are free of antireflux medication at follow-up. Two (7.4%) patients reported about rare episodes of heartburn, which could be treated successfully with proton pump inhibitors. Four (14.(%) patients reported about certain episodes of regurgitation, but did not have an decreased quality of life because of it. Seven (25.9%) patients suffer from mild to moderate dysphagia 5 years postoperatively, the other patients (74.1%) do not have any dysphagia at follow-up. 12 (44.4%) suffer from chest pain sometimes without any other GERD symptoms. Nine of these patients suffer from a concomitant cardiopulmonary disease. Conclusion: Laparoscopic refundoplication after primary failed antireflux surgery results in a high patients satisfaction and significant improvement of patients quality of life with good to excellent symptomatic outcome for a follow-up period of 3 to 5 years after surgery. |
