Introduction:Patient satisfaction is an important goal in the treatment of reflux disease. High satisfaction rate has been reported in patients that undergo Antireflux Surgery (ARS). The aim of this study was to evaluate factors associated with patient dissatisfaction with their operation.
Material and Methods:Data of the 603 patients entered in to the National Registry for Antireflux Surgery and Barrett's Esophagus, a national prospectively collected database of patients who had ARS by one of the 42 participating community and university surgeons. After undergoing surgery patients were followed up in a regular basis via internet or computerized telephony system using speech to text software or through regular clinic sessions. Patients who underwent surgery and had more than 6 months follow up were included.
Results:There were 184(45%) female and 225(55%) male patients with the mean age of 52, median follow up was 3.3 years.Of 409 patients 317 (77.5%) were completely satisfied. Compared to completely satisfied patients, the 92(22.5%) patients not completely satisfied were significantly more likely to have heartburn or regurgitation symptoms (p<0.0001), be using acid suppression medication (p<0.0001), experience dysphagia (p=0.0005), or have residual discomfort at the incision site. (p=0.008)Females were more likely than males to be dissatisfied with the results of their operation. (28% vs. 18%, p=0.02)There was no difference in the incidence of postoperative bloating, abdominal cramping or excessive flatus between satisfied and dissatisfied patients. In addition, patient age did not correlate with satisfaction.
Conclusion:Although most patients are completely satisfied following ARS, dissatisfaction is related to persistent or recurrent reflux symptoms as well as the induction of new symptoms. Consequently attention to technical details that maximize the likelihood of an effective fundoplication and avoidance of dysphagia are imperative to achieve consistent patient satisfaction.