Skip to main content

Advertisement

Log in

Quality of life before and after laparoscopic Nissen fundoplication

  • Original Articles
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Gastroesophageal reflux disease (GERD) is a common disorder in the Western world. The acute disease can usually be managed by medical therapy. To prevent relapse, many patients require lifelong medication. In these patients, laparoscopic antireflux surgery offers a good alternative. The aim of this study was to evaluate the postoperative results and compare pre- and postoperative quality of life after laparoscopic Nissen fundoplication.

Methods

Clinical investigations, including esophageal manometry, pH monitoring, and endoscopy, and a previously validated Quality of Life Index, were performed before and a median of 41 month after antireflux surgery in 75 patients.

Results

After laparoscopic Nissen fundoplication, the percentage of total time with pH <4 decreased from 10.4% to 3.2% on 24-h pH monitoring. The mean pressure of the lower esophageal sphincter improved from 8.1 to 12.3 mmHg. Esophagitis healed in 63 of 66 patients in whom it was present prior to surgery. The overall Quality of Life Index improved significantly from 86 ± 16 to 116 ± 16.

Conclusion

Laparoscopic fundoplication provides effective and durable relief of reflux in patients with GERD. The Quality of Life Index showed significant improvement after surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Blooston M, Zervos E, Gonzales R, Albrink M, Rosemurgy A (1998) Quality of life and antireflux medication use following laparoscopic Nissen fundoplication. Am Surg 64: 509–514

    Google Scholar 

  2. Dallemagne B, Weerts JM, Jehaes C, Markiewicz S, Lombard R (1991) Laparoscopic Nissen fundoplication: preliminary report. Surg Laparosc Endosc 1: 138–143

    PubMed  CAS  Google Scholar 

  3. DeVault KR (1999) Overview of medical therapy for gastroesophageal reflux disease. Gastroenterol Clin North Am 28: 831–845

    Article  PubMed  CAS  Google Scholar 

  4. Eypasch E, Williams JI, Wood-Dauphinee S, Ure BM, Schmülling C, Neugebauer E, Troidl H (1995) Gastrointestinal quality of life index: development, validation and application of a new instrument. Br J Surg 82: 216–222

    Article  PubMed  CAS  Google Scholar 

  5. Kahrilas PJ (1996) Gastroesophageal reflux disease. JAMA 276: 983–988

    Article  PubMed  CAS  Google Scholar 

  6. Kamolz T, Bammer T, Wykypiel H Jr, Pasiut M, Pointner R (2000) Quality of life and surgical outcome after laparoscopic Nissen and Toupet fundoplication: one-year follow-up. Endoscopy 32: 363–368

    Article  PubMed  CAS  Google Scholar 

  7. Klinkenberg-Knol EC, Nelis F, Dent J, Snel P, Mitchell B, Prichard P, Lloyd D, Havu N, Frame MH, Roman J, Walan A, Group LT (2000) Long-term omeprazole treatment in resistant gastroesophageal reflux disease: efficacy, safety, and influence on gastric mucosa. Gastroenterology 118: 661–669

    Article  PubMed  CAS  Google Scholar 

  8. Lonroth H (2000) Efficacy of, and quality of life after, antireflux surgery. Eur J Surg 585: 34–36

    Article  Google Scholar 

  9. Loustarinen ME, Isolauri JO (1999) Surgical experience improves the long-term results of Nissen fundoplication. Scand J Gastroenterol 34: 117–120

    Article  Google Scholar 

  10. Lundell L, Miettinen P, Myrvold HE, Pedersen SA, Thor K, Lamm M, Blomqvist A, Hatlebakk JG, Janatuinen E, Levander K, Nystrom P, Wiklund I (2000) Long-term management of gastro-oesophageal reflux disease with omeprazole or open antireflux surgery: results of a prospective, randomized clinical trial. The Nordic GORD Study Group. Eur J Gastroenterol Hepatol 12: 879–887

    Article  PubMed  CAS  Google Scholar 

  11. Pope CE (1992) The quality of life following antireflux surgery. World J Surg 16: 355–359

    Article  PubMed  Google Scholar 

  12. Rattner DW (2000) Measuring improved quality of life after laparoscopic Nissen fundoplication. Surgery 127: 258–263

    Article  PubMed  CAS  Google Scholar 

  13. Revicki DA, Wood M, Maton PN, Sorensen S (1998) The impact of gastroesophageal reflux disease on health-related quality of life. Am J Med 104: 252–258

    Article  PubMed  CAS  Google Scholar 

  14. Siewert JR, Stein HJ (1996) Nissen fundoplication: technical details, long-term outcome and causes of failure. Dis Esoph 9: 278–284

    Google Scholar 

  15. Stein HJ, DeMeester TR, Hinder RA (1992) Outpatient physiologic testing and surgical management of foregut motility disorders. Curr Probl Surg 29: 415–455

    Article  Google Scholar 

  16. Stein HJ, Feith M, Siewert JR (2000) Malignant degeneration of Barrett’s esophagus: clinical point of view. Recent Results Cancer Res 155: 42–53

    PubMed  CAS  Google Scholar 

  17. Stein HJ, Feussner H, Siewert JR (1994) Surgical therapy of gastroesophageal reflux disease: which patient, which procedure, which approach? Dis Esoph 7: 239–244

    Google Scholar 

  18. Stein HJ, Feussner H, Siewert JR (1996) Failure of antireflux surgery: causes and management strategies. Am J Surg 171: 36–40

    Article  PubMed  CAS  Google Scholar 

  19. Trus TL, Laycock WS, Waring JP, Branum GD, Hunter JG (1999) Improvement in quality of life measures after laparoscopic antireflux surgery. Ann Surg 229: 331–336

    Article  PubMed  CAS  Google Scholar 

  20. Watson DI, Jamieson GG (1998) Autireflux surgery in the laparoscopic era. Br J Surg 85: 1173–1184

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

Online publication: 13 March 2001

Rights and permissions

Reprints and permissions

About this article

Cite this article

Möbius, C., Stein, H.J., Feith, M. et al. Quality of life before and after laparoscopic Nissen fundoplication. Surg Endosc 15, 353–356 (2001). https://doi.org/10.1007/s004640090045

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s004640090045

Key words

Navigation