Does Nissen Fundoplication Provide Lifelong Reflux Control? Symptomatic Outcome After 31-33 Years

Area of Science:

• Gastroenterology
• Surgical Procedures
• Patient Outcomes

Background:

• Gastroesophageal reflux disease (GERD) affects many, with surgery indicated after medical treatment failure.
• Long-term PPI use post-fundoplication raises concerns about surgical durability.
• This study examines outcomes of open Nissen fundoplication (ONF) after over 31 years.

Purpose of the Study:

• To evaluate the long-term efficacy and durability of open Nissen fundoplication (ONF).
• To assess symptom resolution and quality of life after ONF in GERD patients.
• To compare medication use post-ONF with previous long-term follow-up studies.

Main Methods:

• 38 patients underwent ONF; long-term outcomes assessed via questionnaires in 2015.
• Symptom evaluation included GSRS, Visick grading, VAS, DeMeester-Johnson scale, and 15D tool.
• 24 surviving patients were contacted, with 17 participating (70.8% response rate).

Main Results:

• Significant resolution of typical GERD symptoms observed in participants.
• Dysphagia was minimal to none in 81.3% of patients.
• Health-related quality of life, measured by the 15D score, was comparable to the general population (p=0.912).
• Only 15.8% used antireflux medication post-op, with 10.6% using it continuously.

Conclusions:

• Successful ONF can provide lifelong relief from GERD symptoms.
• ONF normalizes health-related quality of life in GERD patients.
• This study shows lower PPI use compared to prior long-term follow-up studies.