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Effect of surgeon on outcome of antireflux surgery

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Abstract

Background

We sought to determine whether subjective outcomes one or more years after antireflux surgery are affected by the operating surgeon.

Methods

We reviewed records of patients who had antireflux surgery from June 2000 to June 2002 and mailed the patients a 19-item survey that focused on current medication use, postoperative symptom improvement, and satisfaction with surgery. We tested the significance of predictor variables using chi-squared and Fisher exact tests for categorical variables and analysis of variance for continuous variables.

Results

We mailed the survey to 74 patients. Ninety-one percent of the operations were initially laparoscopic, with 5 (7%) subsequently converting to open. Ninety-five percent of patients were taking protein pump inhibitors (PPIs) preoperatively. Surgeons (n = 7) were divided into four groups, with the four surgeons who did two or fewer procedures in one group. Fifty-two of 74 patients (70%) responded to the survey (mean age, [SD] 44 [21] years, 37% male). The mean duration of followup was 2.1 [0.46] years. Thirty-eight percent of patients were taking medications for gastroesophageal reflux disease at the time of survey completion. It was found that the surgeon had an influence on patients’ perceptions of the success of the surgery and whether having surgery was a good idea. We did not identify a statistically significant effect of the surgeon on preoperative symptom severity, postoperative ability to belch, dysphagia, medication use, and lifestyle.

Conclusion

A patient’s surgeon has an effect on satisfaction with antireflux surgery. Further research should clarify specific practices of the surgeon (patient selection, operative technique, followup) associated with best outcome.

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Authors and Affiliations

  1. Divisions of General Surgery and Clinical Decision Making and Health Care, University Health Network, Toronto, Ontario, Canada

    Pavi Singh Kundhal, Julie L. Harnish & David R. Urbach

  2. Toronto General Hospital Research Institute, 200 Elizabeth Street, NU 10-214, M5G 2C4, Toronto, Ontario, Canada

    David R. Urbach

Authors
  1. Pavi Singh Kundhal
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  2. Julie L. Harnish
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  3. David R. Urbach
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Corresponding author

Correspondence to David R. Urbach.

Additional information

Presented in poster form at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), Denver, Colorado, March 31–April 3, 2004.

This work was supported in part by the Canadian Association of General Surgeons and the physicians of Ontario through the Physicians’ Services Incorporated Foundation. Dr. Urbach is a Career Scientist of the Ontario Ministry of Health and Long-Term Care, Health Research Personnel Development Program.

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Kundhal, P.S., Harnish, J.L. & Urbach, D.R. Effect of surgeon on outcome of antireflux surgery. Surg Endosc 21, 902–906 (2007). https://doi.org/10.1007/s00464-006-9024-8

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  • DOI: https://doi.org/10.1007/s00464-006-9024-8

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