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Impact of Gender and Age on the Long-Term Outcome of Laparoscopic Fundoplication

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Abstract

Background

It has been suggested that gender and age could be factors that influence the likelihood of success following antireflux surgery, and our anecdotal impression has been that the outcome following Nissen fundoplication in older women is often disappointing. If correct, characterization of the extent of any differences in outcome might help patient selection and, hence, surgical outcomes. Therefore, in this study we investigated the impact of gender and age on longer-term clinical outcomes following laparoscopic fundoplication.

Methods

Perioperative and follow-up data from patients undergoing laparoscopic fundoplication in our departments have been collected prospectively and stored in a database. From the database, patients who had undergone either an anterior 180° partial or 360° total laparoscopic fundoplication for gastroesophageal reflux and completed 5 years clinical follow-up were identified. Patients were classified according to gender and age, and outcome data were analyzed to determine differences. Analog scales of 0–10 were used to determine symptoms of heartburn and dysphagia and overall satisfaction.

Results

Seven hundred three patients were studied (58% males). Females were less satisfied with the outcome (score = 7.8 ± 2.8 vs. 8.4 ± 2.5, P = 0.0036), and had higher scores for heartburn (2.0 ± 2.7 vs. 1.2 ± 2.2; P = 0.0001) and dysphagia for solid food (2.7 ± 2.9 vs. 2.0 ± 2.5, P = 0.0049) compared to males. Revisional procedures were undertaken more frequently in females (15.5% vs. 8.4%, P = 0.0038). Age had no impact on any clinical outcome.

Conclusions

While the outcome for laparoscopic fundoplication is not influenced by age, the outcome for women is poorer than in males.

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Authors and Affiliations

  1. Department of Surgery, Flinders Medical Centre, Flinders University, Bedford Park, SA, Australia

    Plauto E. Beck & David I. Watson

  2. Discipline of Surgery, Royal Adelaide Hospital, University of Adelaide, Adelaide, SA, Australia

    Peter G. Devitt, Philip A. Game & Glyn G. Jamieson

  3. Department of Surgery, Flinders Medical Centre, Flinders University, Room 3D211, Bedford Park, SA, 5042, Australia

    David I. Watson

Authors
  1. Plauto E. Beck
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  2. David I. Watson
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  3. Peter G. Devitt
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  4. Philip A. Game
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  5. Glyn G. Jamieson
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Corresponding author

Correspondence to David I. Watson.

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Beck, P.E., Watson, D.I., Devitt, P.G. et al. Impact of Gender and Age on the Long-Term Outcome of Laparoscopic Fundoplication. World J Surg 33, 2620–2626 (2009). https://doi.org/10.1007/s00268-009-0216-y

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  • DOI: https://doi.org/10.1007/s00268-009-0216-y

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