Abstracts
1999 Digestive Disease Week

# 2103 IMPROVEMENT OF PSYCHOLOGICAL WELL BEING AND GASTROINTESTINAL SYMPTOMS BY LAPAROSCOPIC NISSEN FUNDOPLICATION
David W Rattner, MA Gen Hosp, Boston, MA

Introduction: While the correction of pathologic gastroesophageal reflux by laparoscopic nissen fundoplication(LNF) has been well documented, the psychological profiles of patients with this disease and the impact on their quality of life(QOL) are less well understood. We obtained a baseline psychological profile and measured the impact of LNF on patients' QOL with two standardized instruments, the psychological general well-being index (PGWB) and the gastrointestinal symptoms rating scale(GSRS) in 34 consecutive patients. Patients filled out PGWB and GSRS surveys preoperatively and at 2 weeks, 2 months, and 12 months postoperatively. Data were collcted in a blinded fashion by a study nurse and analyzed after completion of the study. Data are expressed as mean ± standard deviation.
Results: The mean preoperative PGWB score (69.6 ± 17.3) of study patients with GERD was lower than that expected for a healthy population (78.4 ± 13.2) based on Rand Corporation Study data (p=.02). This was primarily attributable to low scores in the general health domain of the questionnaire although LNF patients also had low scores in the vitality and positive well being domains of the PGWB scale. LNF improved the PGWB score to a normal level (78.7 ± 19.3) (p= .04 vs. pre-op PGWB score) at 12 months post surgery. Likewise the GSRS showed improvement from 34.7 ± 7.8 to 28.1 ±10 (p=.008). The improvement in GSRS was due to improvement in the heartburn (7.12 ± 2.4 to 2.72 ± 1.2 p <.001 ) and abdominal pain (6.58 ± 2.5 to 4.92 ± 1.6 p=.006) domains of the scale. LNF had no impact on the diarrhea, indigestion, and obstipation domains of the GSRS.
Conclusions: Patients with GERD who are candidates for LNF have low psychological and general well being scores which are restored to normal levels by successful LNF. When compared with baseline measurements, LNF effectively relieved heartburn and did not cause significant new gastrointestinal complaints.

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