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Long-term outcomes after laparoscopic antireflux surgery
Brant K Oelschlager1, Elina Quiroga, Juan D Parra
1Swallowing Center, Department of Surgery, University of Washington, Seattle, WA 98195-6410, USA.
The American Journal of Gastroenterology
|November 1, 2007
Summary
Laparoscopic antireflux surgery (LARS) effectively treats GERD long-term. Younger men without dysphagia experience the best outcomes following LARS.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Patient Outcomes
Background:
- Gastroesophageal reflux disease (GERD) significantly impacts quality of life.
- Laparoscopic antireflux surgery (LARS) is a common treatment for GERD.
- Long-term outcomes and predictive factors for LARS success require further elucidation.
Purpose of the Study:
- To evaluate the long-term efficacy of laparoscopic antireflux surgery (LARS).
- To identify factors predicting successful outcomes after LARS for GERD.
Main Methods:
- A prospective database of 441 patients undergoing LARS from 1993-1999 was analyzed.
- Follow-up data was obtained in 2004 for 288 patients (65%) via a private investigator.
- Preoperative symptoms and esophageal function studies were recorded.
Main Results:
- At a median of 69 months, significant symptom improvement was observed: heartburn (67% resolved), regurgitation (70% resolved).
- Predictors of symptom resolution included preoperative heartburn, male gender, and younger age.
- Negative predictors were preoperative dysphagia, airway symptoms, bloating, and impaired esophageal motility. Postoperative diarrhea and bloating were observed in 11% and 9% of patients, respectively.
Conclusions:
- Laparoscopic antireflux surgery (LARS) offers durable relief for GERD symptoms.
- Younger male patients without preoperative dysphagia are associated with superior long-term outcomes.
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