Assessment of Quality of Life after Laparoscopic Nissen Fundoplication in Patients with Gastroesophageal Reflux Disease |
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Authors: | Deniz Balci Ahmet G Turkcapar |
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Institution: | (1) Department of General Surgery, Ankara University, Guvenlik cad, 59/5 A Ayranci, Ankara, Turkey, 06550 |
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Abstract: | Background In this study two different quality of life items are compared, and correlation of patient satisfaction with preoperative
and postoperative symptoms after laparoscopic Nissen fundoplication (LNF) for chronic gastroesophageal reflux disease is evaluated.
Materials and Methods Between December 2002 and December 2004, 60 patients with a diagnosis of chronic gastroesophageal reflux disease scheduled
for laparoscopic Nissen fundoplication were recruited prospectively and volunteered to participate in this study. Patients
underwent endoscopy, and their disease-specific symptoms were scored on a scale. Quality of life was measured preoperatively
and in the first and sixth postoperative months with two questionnaires: Short Form-36 (SF 36) (preoperatively) and the Gastroesophageal
Reflux Disease—Health-Related Quality of Life (GERD-HRQL) (postoperatively).
Results In more than 90% of the patients, typical symptoms (regurgitation and pyrozis) were controlled postoperatively (p < 0.001). In the first postoperative month, however, dysphagia (early dysphagia) was seen in 46 (76%) patients, whereas in
the sixth postoperative month (late dysphagia) its incidence decreased to only 2 (3.3%) patients. Similarly, in the first
postoperative month 42 (70%) patients had gas bloating, but the incidence of this symptom decreased to 26 (43.3%) patients
by the sixth month (p = 0.01). The quality-of-life measurements obtained from both SF 36 and GERD-HRQL showed that quality of life of the patients
improved significantly in the related domain of each item after surgery (p < 0.001).
Conclusions Laparoscopic Nissen fundoplication is an effective operation that controls the typical symptoms and improves the quality of
life of patients, but new-onset symptoms affect postoperative well-being. For closer evaluation of the benefits of the operation,
we need new questionnaires that comprehensively evaluate the symptom spectrum of GERD both preoperatively and postoperatively. |
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