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Quality of Life Convergence of Laparoscopic and Open Antireflux Surgery for Gastroesophageal Reflux Disease
Aisha Violette, Vic Velanovich; Surgery, Henry Ford Hospital, Detroit, MI

Background: Although laparoscopic antireflux surgery (LARS) has become the surgical treatment of choice for gastroesophageal reflux disease (GERD), it is unclear whether the quality of life (QoL) advantage of LARS over open antireflux surgery (OARS) persists in the long term. The purpose of this study was to compare long-term QoL between LARS and OARS patients. Methods: A prospectively gathered database of all patients who underwent either LARS or OARS for symptomatic GERD was reviewed. Preoperatively, patients completed the GERD-HRQL symptom severity questionnaire (best score 0, worst score 50), and the SF-36 generic QoL instrument (8 domains, physical functioning, PF; role-physical, RP; role-emotional, RE; bodily pain, BP; vitality, VT; mental health, MH; social functioning, SF; general health, GH. Best score 100, worst score 0). Postoperatively, patients completed both questionnaires at 6 weeks and at least 1 year. Data are presented as medians and statistically analyzed using the Mann-Whitney U-test. A beta-error was determined to assess adequacy of sample size. Results: 289 patients underwent either LARS and 124 OARS. The table presents the median scores. At 6 weeks, there were statistically significantly better scores for LARS in the domains of PF, RP, RE, BP and SF. However, after 1 year, there were no statistically significant differences. The beta-error for non-statistically significant differences were all <0.2, which is considered an adequate sample size. Conclusion: Although LARS does produce better QoL scores in the early postoperative period, after 1 year, these scores converge.

 

Total GERD-HRQL

PF

RE

RP

BP

VT

MH

SF

GH

Preop

27

85

100

100

61

50

72

75

62

LARS 6 weeks

4

95

100

100

74

55

84

100

72

OARS 6 weeks

3

75

0

67

62

50

72

75

72

LARS >1 year

3

90

100

100

79

55

84

100

75

OARS >1 year

1

85

100

100

92

63

92

100

72


All data are median scores


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