Abstract
Background
Currently, evaluation of patient satisfaction and quality-of-life data to estimate the outcome of laparoscopic antireflux surgery is an important issue. This study aimed first to report the midterm results for the surgical management of gastroesophageal reflux disease (GERD) by laparoscopic fundoplication and to evaluate surgical outcome, including quality of life and patient satisfaction. The second aim was to determine whether preoperative quality-of-life measurement can predict which patients will be satisfied with antireflux surgery.
Methods
The current prospective study evaluated the outcome of the quality-of-life data for 41 patients (13 men and 28 women) who underwent laparoscopic fundoplication in the author’s department of surgery between 1 January 2002 and 31 May 2003. The mean age of the patients was 41 years. Quality of life was measured by using a new quality-of-life instrument (QOLARS) developed and validated by the author’s study group. The patients completed the QOLARS questionnaire before surgery, then 6 weeks, 1 year, and 3 years after surgery.
Results
Before surgery, all the patients had a poor quality of life. The general quality-of-life and heartburn scores improved significantly within 6 weeks after surgery and showed further improvement by the end of the first postoperative year, then remained stable 3 years after surgery. The patients who became completely free of reflux-related symptoms were divided into two groups according to their satisfaction with the operative result. The patients dissatisfied with surgery had significantly worse median preoparative scores in four domians (physical functioning, emotional functioning, sleep disturbance, constipation) than the patients satisfied with the procedure.
Conclusions
The findings show that QOLARS is a sensitive tool for assessing surgical outcome after laparoscopic antireflux surgery. The quality-of-life response closely follows the clinical outcome of surgical treatment, reflecting its side effects as well. This study suggests that a generic quality-of-life scale can preoperatively identify patients with GERD who are likely to be dissatisfied with antireflux surgery.
Similar content being viewed by others
References
Anvari M, Allen C (2003) Five-year comprehensive outcomes evaluation in 181 patients after laparoscopic Nissen fundoplication. J Am Coll Surg 196: 51–57; discussion 57–58, author reply 58–59
Barrat C, Capelluto E, Catheline JM, Champault GG (2001) Quality of life 2 years after laparoscopic total fundoplication: a prospective study. Surg Laparosc Endosc Percutan Tech 11: 347–350
Booth MI, Jones L, Stratford J, Dehn TCB (2002) Results of laparoscopic Nissen fundoplication at 2–8 years after surgery. Br J Surg 89: 476–481
Contini S, Bertelé A, Nervi G, Zinicola R, Scarpignato C (2002) Quality of life for patients with gastrooesophageal reflux disease 2 years after laparoscopic fundoplication. Surg Endosc 16: 1555–1560
Dallemagne B, Weerts J, Markiewicz S, Dewandre JM, Wahlen C, Monami B, Jehaes C (2006) Clinical results of laparoscopic fundoplication at ten years after surgery. Surg Endosc 20: 159–165
Dassinger MS, Torquati A, Houston HL, Holzman MD, Sharp KW, Richards WO (2004) Laparoscopic fundoplication: 5-year follow-up. Am Surg 70: 691–695
Frank A, Granderath FA, Kamolz T, Schweiger UM, Pointner R (2002) Quality of life, surgical outcome, and patient satisfaction three years after laparoscopic Nissen fundoplication. World J Surg 26: 1234–1238
Fuchs KH, Breithaupt W, Fein M, Maroske J, Hammer I (2005) Laparoscopic Nissen repair: indications, techniques, and long-term benefits. Langenbecks Arch Surg 390: 197–202
Kamolz T, Granderath FA, Bammer T, Wykypiel H Jr, Pointner R (2002) Floppy Nissen vs Toupet laparoscopic fundoplication: quality-of-life assessment in a 5-year follow-up (part 2). Endoscopy 34: 917–922
Kamolz T, Granderath FA, Pointner R (2003) Does major depression in patients with gastroesophageal reflux disease affect the outcome of laparoscopic antireflux surgery? Surg Endosc 17: 55–60
Korolija D, Sauerland S, Wood-Dauphinée S, Abbou CC, Eypasch E, Caballero MG, Lumsden MA, Millat B, Monson JR, 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
Lafullarde T, Watson DI, Jamieson GG, Myers JC, Game PA, Devitt PG (2001) Laparoscopic Nissen fundoplication: five-year results and beyond. Arch Surg 136: 180–184
Möbius C, Stein HJ, Feith M, Feussner H, Siewert JR (2001) Quality of life before and after laparoscopic Nissen fundoplication. Surg Endosc 15: 353–356
Pessaux P, Arnaud JP, Delattre JF, Meyer C, Baulieux J, Mosnier H (2005) Laparoscopic antireflux surgery: five-year results and beyond in 1340 patients. Arch Surg 140: 946–951
Quigley EM, Hungin AP (2005) Review article: quality-of-life issues in gastro-oesophageal reflux disease. Aliment Pharmacol Ther 22(Suppl 1): 41–47
Rattner DW (2000) Measuring improved quality of life after laparoscopic Nissen fundoplication. Surgery 127: 258–263
Velanovich V (2000) Quality of life and severity of symptoms in gastrooesophageal reflux disease: a clinical review. Eur J Surg 166: 516–525
Velanovich V (2003) The effect of chronic pain syndromes and psychoemotional disorders on symptomatic and quality-of-life outcomes of antireflux surgery. J Gastrointest Surg 7: 53–58
Velanovich V (2004) Using quality-of-life measurements to predict patient satisfaction outcomes for antireflux surgery. Arch Surg 139: 621–625
Zéman ZS, Rózsa S, Tarkó E, Tihanyi T (2005) Psychometric documentation of a quality-of-life questionnaire for patients undergoing antireflux surgery (QOLARS). Surg Endosc 19: 257–261
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zéman, Z., Tihanyi, T. Quality of life and patient satisfaction after laparoscopic antireflux surgery using the QOLARS questionnaire. Surg Endosc 21, 1418–1422 (2007). https://doi.org/10.1007/s00464-006-9180-x
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00464-006-9180-x