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Related Experiment Videos

Laparoscopic fundoplication.

P M Markus1, O Horstmann, C Kley

  • 1Department of Surgery, Georg-August University of Göttingen, Robert Kochstrasse 40, 37075 Göttingen, Germany.

Surgical Endoscopy
|April 19, 2002
PubMed
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Laparoscopic Nissen fundoplication (LNF) improves quality of life in gastroesophageal reflux disease (GERD) patients, even with persistent reflux. Post-surgery QoL scores increased significantly, suggesting subjective well-being is a key outcome.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Patient Outcomes

Background:

  • Chronic gastroesophageal reflux disease (GERD) poses significant challenges to patient well-being.
  • Laparoscopic Nissen fundoplication (LNF) is a common surgical intervention for GERD.
  • Assessing LNF effectiveness typically involves objective measures like pH studies and subjective quality-of-life (QoL) assessments.

Purpose of the Study:

  • To evaluate the effectiveness of laparoscopic Nissen fundoplication (LNF) in managing chronic gastroesophageal reflux disease (GERD).
  • To correlate objective pH study data with subjective quality-of-life improvements following LNF.
  • To investigate the hypothesis that improved QoL post-LNF may not directly correlate with normalized pH values.

Main Methods:

  • Seventy GERD patients, including 14 with Barrett's esophagus, underwent LNF.

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  • Pre- and post-operative assessments included 24-h pH studies, endoscopy, and a validated quality-of-life questionnaire.
  • Data were analyzed to compare objective reflux measures with subjective QoL improvements.

    • Main Results:

    • LNF successfully reduced reflux in most patients; six patients had persistent reflux post-surgery.
    • Despite persistent reflux, these six patients showed significant improvement in the Gastrointestinal Quality of Life Index (GQLI).
    • Quality-of-life improvements were comparable between patients with and without Barrett's esophagus and did not strictly correlate with normalized pH levels.

    Conclusions:

    • A weak correlation exists between objective pH study findings and subjective quality-of-life assessments after LNF.
    • Patient-reported quality of life significantly improves following LNF, irrespective of persistent objective reflux.
    • Objective measures like pH studies and endoscopy are recommended alongside QoL assessments for a comprehensive evaluation of antireflux surgery effectiveness.