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Evaluation of short-term and long-term results after laparoscopic antireflux surgery: esophageal manometry and 24-h pH monitoring versus quality of life index

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Abstract

Purpose

The objective of this long-term study is to compare data on postoperative quality of life with objective functional measurements in patients with gastroesophageal reflux disease who have undergone laparoscopic antireflux surgery.

Methods

Between 1995 and 2005, 162 patients with gastroesophageal reflux disease underwent laparoscopic surgery. A minimum of 4 years after surgery, 60 patients were contacted at random, 29 of whom agreed to follow-up examination. The following examinations were performed preoperatively, 6 months postoperatively, and 4–12 years postoperatively: esophageal manometry, 24-h gastroesophageal pH-metry, and assessment of patient quality of life based on the gastrointestinal quality of life index (GIQLI).

Results

The number of postsurgical reflux episodes was reduced significantly, both at 6 months and at 4 or more years after surgery. The number of episodes dropped from 183 before surgery to 58 at 6 months after surgery and remained constant ≥4 years later. Surgery also produced a significant drop in reflux time, seen both 6 months and ≥4 years later. Six months after surgery, the median reflux time had fallen from 134 min (preoperatively) to 27 min, and at ≥ 4 years it was still significantly reduced at 35 min. Sphincter length (median preoperative length, 3 cm; median postoperative length (at 6 months and at ≥4 years), 4 cm) and sphincter pressure (median preoperative pressure, 3 mmHg; median at 6 months, 12 mmHg; median at ≥4 years, 10.9 mmHg) were significantly improved by surgery as well. Finally, surgery produced an improvement in quality of life. The median preoperative GIQLI was 102, while at 6 months after surgery it was 113 and at ≥4 years after surgery it was 124.

Conclusion

Laparoscopic fundoplication guarantees long-term improvement in symptoms and quality of life for patients suffering from gastroesophageal reflux disease. The effectiveness of reflux surgery can thus be demonstrated by long-term quality of life assessments and postoperative functional measurements. No statistically significant correlation between total score (DeMeester) and GIQLI could be demonstrated.

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References

  1. Koop H, Schepp W, Müller-Lissner S, Madisch A, Micklefield G, Messmann H, Fuchs KH, Hotz J (2005) Consensus conference of the DGVS on gastroesophageal reflux. Z Gastroenterol 43(2):163–164

    Article  PubMed  CAS  Google Scholar 

  2. Fuchs KH, Breithaupt W (2011) Benign esophageal disorders. Gastroesophageal reflux disease, diffuse esophageal spasm, achalasia. Chirurg 82(3):271–279

    Article  PubMed  Google Scholar 

  3. Herbella FA, Patti MG (2010) Gastroesophageal reflux disease: from pathophysiology to treatment. World J Gastroenterol 16:3745–3749

    Article  PubMed  Google Scholar 

  4. Raue W, Menenakos C, Braumann C, Trache D, Hartmann J (2009) Evaluation of postoperative long-term quality of life after laparoscopic anterior partial fundoplication in the treatment of gastroesophageal reflux disease. Dig Surg 26(5):413–417

    Article  PubMed  Google Scholar 

  5. Strate U, Emmermann A, Fibbe C, Layer P, Zornig C (2008) Laparoscopic fundoplication: Nissen versus Toupet two-year outcome of a prospective randomized study of 200 patients regarding preoperative esophageal motility. Surg Endosc 22(1):21–30

    Article  PubMed  CAS  Google Scholar 

  6. Shan CX, Zhang W, Zheng XM, Jiang DZ, Liu S, Qiu M (2010) Evidence-based appraisal in laparoscopic Nissen and Toupet fundoplications for gastroesophageal reflux disease. World J Gastroenterol 16(24):3063–3071

    Article  PubMed  Google Scholar 

  7. Soyer T, Karnak I, Tanyel FC, Senocak ME, Ciftci AO, Büyükpamukçu N (2007) The use of pH monitoring and esophageal manometry in the evaluation of results of surgical therapy for gastroesophageal reflux disease. Eur J Pediatr Surg 17(3):158–162

    Article  PubMed  CAS  Google Scholar 

  8. Broeders JA, Draaisma WA, Bredenoord AJ, Smout AJ, Broeders IA, Gooszen HG (2011) Impact of symptom–reflux association analysis on long-term outcome after Nissen fundoplication. Br J Surg 98(2):247–254

    Article  PubMed  CAS  Google Scholar 

  9. Broeders JA, Draaisma WA, de Vries DR, Bredenoord AJ, Smout AJ, Gooszen HG (2009) The preoperative reflux pattern as prognostic indicator for long-term outcome after Nissen fundoplication. Am J Gastroenterol 104(8):1922–1930

    Article  PubMed  Google Scholar 

  10. Fein M, Bueter M, Thalheimer A, Pachmayr V, Heimbucher J, Freys SM, Fuchs KH (2008) Ten-year outcome of laparoscopic antireflux surgery. J Gastrointest Surg 12(11):1893–1899

    Article  PubMed  CAS  Google Scholar 

  11. Ludwig K, Bernhardt J, Amtsberg G, Patrzyk M, Wilhelm L, Hoene A (2003) Pathophysiological measurement and results after laparoscopic fundoplication for gastroesophageal reflux disease. Surg Today 33(2):89–94

    Article  PubMed  Google Scholar 

  12. Kamolz T, Wykypiel H Jr, Bammer T, Pointner R (1998) Quality of life after laparoscopic antireflux surgery—Nissen fundoplication. Chirurg 69:947–950

    Article  PubMed  CAS  Google Scholar 

  13. Korolija D, Sauerland S, Wood-Dauphinée S, Abbou CC, Eypasch E, García Caballero M, Lumsden MA, Millat B, Monson JRT, Nilsson G, Pointner R, Schwenk W, Shamiyeh A, Szold A, Targarona E, Ure B, Neugebauer E (2004) Evaluation of quality of life after laparoscopic surgery. Evidence-based guidelines of the European Association for Endoscopic Surgery. Surg Endosc 18:879–897

    Article  PubMed  CAS  Google Scholar 

  14. Kleimann E, Halbfaß HJ (1999) Laparoscopic antireflux surgery for gastrooesophageal reflux disease: report on a 4-year experience. Chirurg 70:456–463

    Article  PubMed  CAS  Google Scholar 

  15. Koch OO, Kaindlstorfer A, Antoniou SA, Asche KU, Granderath FA, Pointner R (2012) Laparoscopic Nissen versus Toupet fundoplication: objective and subjective results of a prospective randomized trial. Surg Endosc 26:413–422

    Article  PubMed  Google Scholar 

  16. Meier C, Niedermann F, Wehrli H (2000) Laparoscopic fundoplication for gastroesophageal reflux: experience with 49 surgical patients (1994–1999). Schweiz Med Wochenschr 130(40):1399–1406

    PubMed  CAS  Google Scholar 

  17. Balsara KP, Shah CR, Hussain M (2008) Laparoscopic fundoplication for gastro-esophageal reflux disease: an 8 year experience. J Minim Access Surg 4(4):99–103

    Article  PubMed  CAS  Google Scholar 

  18. van der Peet DL, Klinkenberg-Knol EC, Eijsbouts QA, van den Berg M, de Brauw LM, Cuesta MA (1998) Laparoscopic Nissen fundoplication for the treatment of gastroesophageal reflux disease (GERD). Surgery after extensive conservative treatment. Surg Endosc 12(9):1159–1163

    Article  PubMed  Google Scholar 

  19. Antoniou SA, Delivorias P, Antoniou GA, Natsiopoulos I, Kalambakas A, Dalenbäck J, Makridis C (2008) Symptom-focused results after laparoscopic fundoplication for refractory gastroesophageal reflux disease—a prospective study. Langenbecks Arch Surg 393(6):979–984

    Article  PubMed  Google Scholar 

  20. Müller-Stich BP, Holzinger F, Kapp T, Klaiber C (2006) Laparoscopic hiatal hernia repair—long-term outcome with the focus on the influence of mesh reinforcement. Surg Endosc 20:380–384

    Article  PubMed  Google Scholar 

  21. Müller-Stich BP, Köninger J, Müller-Stich BH, Schäfer F, Warschkow R, Mehrabi A, Gutt CN (2009) Laparoscopic mesh-augmented hiatoplasty as a method to treat gastroesophageal reflux without fundoplication: single-center experience with 306 consecutive patients. Am J Surg 198:17–24

    Article  PubMed  Google Scholar 

  22. Davis CS, Baldea A, Johns JR, Joehl RJ, Fisichella PM (2010) The evolution and long-term results of laparoscopic antireflux surgery for the treatment of gastroesophageal reflux disease. JSLS 14(3):332–341

    Article  PubMed  CAS  Google Scholar 

  23. Wykypiel H, Gadenstaetter M, Klaus A, Klingler P, Wetscher GJ (2005) Nissen or partial posterior fundoplication: which antireflux procedure has a lower rate of side effects? Langenbecks Arch Surg 390(2):141–147

    Article  PubMed  Google Scholar 

  24. Zügel N, Jung C, Bruer C, Sommer P, Breitschaft K (2002) A comparison of laparoscopic Toupet versus Nissen fundoplication in gastroesophageal reflux disease. Langenbecks Arch Surg 386(7):494–498

    Article  PubMed  Google Scholar 

  25. Valiati W, Fuchs KH, Valiati L, Freys SM, Fein M, Maroske J, Tigges H, Thiede A (2000) Laparoscopic fundoplication—short- and long-term outcome. Langenbecks Arch Surg 385(5):324–328

    Article  PubMed  CAS  Google Scholar 

  26. Amato G, Limongelli P, Pascariello A, Rossetti G, Del Genio G, Del Genio A, Iovino P (2008) Association between persistent symptoms and long-term quality of life after laparoscopic total fundoplication. Am J Surg 196(4):582–586

    Article  PubMed  Google Scholar 

  27. Gee DW, Andreoli MT, Rattner DW (2008) Measuring the effectiveness of laparoscopic antireflux surgery: long-term results. Arch Surg 143(5):482–487

    Article  PubMed  Google Scholar 

  28. Nocon M, Labenz J, Jaspersen D, Leodolter A, Richter K, Vieth M, Lind T, Malfertheiner P, Willich SN (2009) Health-related quality of life in patients with gastro-oesophageal reflux disease under routine care: 5-year follow-up results of the ProGERD study. Aliment Pharmacol Ther 29(6):662–668

    Article  PubMed  CAS  Google Scholar 

  29. Fox M, Forgacs I (2006) Gastro-oesophageal reflux disease. BMJ 332(7533):88–93

    Article  PubMed  Google Scholar 

  30. Papasavas PK, Keenan RJ, Yeaney WW, Caushaj PF, Gagné DJ, Landreneau RJ (2003) Effectiveness of laparoscopic fundoplication in relieving the symptoms of gastroesophageal reflux disease (GERD) and eliminating antireflux medical therapy. Surg Endosc 17(8):1200–1205

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of General, Visceral, Thoracic and Vascular Surgery, Universitätsmedizin, Ernst-Moritz-Arndt-University, Ferdinand Sauerbruchstr, 17457, Greifswald, Germany

    Katarzyna Blazejczyk, Andreas Hoene, Anne Glitsch, Alexandra Busemann, Claus Dieter Heidecke & Maciej Patrzyk

  2. General, Visceral and Minimal-Invasive Surgery, Park Klinik Weissensee, Berlin, Germany

    Katarzyna Blazejczyk

Authors
  1. Katarzyna Blazejczyk
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  2. Andreas Hoene
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  3. Anne Glitsch
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  4. Alexandra Busemann
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  5. Claus Dieter Heidecke
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  6. Maciej Patrzyk
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Correspondence to Maciej Patrzyk.

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Blazejczyk, K., Hoene, A., Glitsch, A. et al. Evaluation of short-term and long-term results after laparoscopic antireflux surgery: esophageal manometry and 24-h pH monitoring versus quality of life index. Langenbecks Arch Surg 398, 1107–1114 (2013). https://doi.org/10.1007/s00423-013-1118-x

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  • DOI: https://doi.org/10.1007/s00423-013-1118-x

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