Quality-of-life assessments in evaluation of laparoscopic Rosetti fundoplication

It has recently been suggested that quality-of-life investigations should be included in the evaluation of new medical and surgical regimens. We present the quality-of-life evaluations for the first 40 consecutive patients undergoing laparoscopic antireflux surgery at our department. Two well-established and validated questionnaires, the Psychological General Well Being (PGWB) Index, and the Gastrointestinal Symptom Rating Scale (GSRS), were used. The PGWB gives a general measure of patients' well-being while the GSRS concentrates on gastrointestinal complaints. In untreated reflux esophagitis patients, the PGWB score is very low. We found normal PBWB scores preoperatively during optimal medical treatment with potent acid inhibition. The average score became significantly better (than on medical treatment, P < 0.05) 1 month postoperatively, after which it fell off to normal values 3 and 8-12 months after operation. The GSRS scores were good in all subgroups postoperatively, especially regarding reflux syndrome, where scores were significantly (P < 0.05) better than on medical treatment.

After laparoscopic antireflux surgery, patients had good quality-of-life scores, better than untreated patients and as good as or better than on optimal medical treatment. Different treatment regimens could be discriminated by adding the patients' view of the treatment effect. We suggest that quality-of-life effects should be included when evaluating new regimens in laparoscopic surgery.