IntroductionAntireflux surgery is recognised as being an effective but invasive treatment for gastroesophageal reflux (GORD) disease. Minimal access surgery has made this a more acceptable treatment and patients are increasingly choosing to have surgery in preference to long term acid suppression. As part of the West of Scotland antireflux surgery audit we have collated pre and post operative symptom profile for patients undergoing laparoscopic fundoplication. We have already shown an improvement in quality of life within this patient group post operatively and aim here to explore the changes in symptom profile and overall patient satisfaction following laparoscopic antireflux surgery.Patients and MethodsBetween October 1996 and August 2002, 504 patients had laparoscopic antireflux surgery in the West of Scotland. During this time pre and 12 month post operative assessment of these patients’ reflux related symptoms was carried out by postal questionnaires assessing the following symptoms: Heartburn, dysphagia, regurgitation, epigastric pain, abdominal bloating and diarrhoea. 315 patients completed pre and post operative data (62.5% completion rate). There were 123F, 192M; age median 46 (16-81 years). 178 had a Nissen fundoplication, 113 Toupet fundoplication, 13 Watson fundoplication and 11 patient's fundoplication type was not documented.Patients scored their symptoms using a visual analogue scoring system (0 corresponding to no symptoms and 9 corresponding to worst possible symptoms). In addition, patients were asked to give an overall score between 0 and 10, rating their overall satisfaction with their antireflux surgery at 12 months post operatively.Statistical significance was evaluated comparing pre and post operative symptom scores using the paired Wilcoxon signed rank test.ResultsSee table.Patients’ overall satisfaction score had a median of 9 (range 0-10)ConclusionLaparoscopic antireflux surgery significantly improves symptoms post operatively and patients are highly satisfied with their antireflux surgery at 12 months.
Results

Symptoms	Pre-op Score Mean (range 0-9)	Post-op Score Mean (range 0-9)	Statistics
Heartburn	7.24	1.5	p<0.0001
Dysphagia	2.79	1.96	p<0.001
Regurgitation	6.89	1.25	p<0.0001
Abdominal Bloating	4.87	3.95	p<0.0001
Diarrhoea	2.88	2.50	p=ns
Epigastric pain	3.50	2.38	p<0.0001