Quality of life after Nissen fundoplication in patients with gastroesophageal reflux disease: Comparison between long- and short-term follow-up

• Published in: Journal of minimal access surgery Vol. 14; no. 3; pp. 213 - 220
• Main Authors: Castelijns, P, Ponten, J, vd Poll, M, Bouvy, N, Smulders, J
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.07.2018; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Care and treatment; Development and progression; Endoscopy; Fundoplication; Gastroenterology; Gastroesophageal reflux; Gastroesophageal reflux disease; Health aspects; Hernias; Hospitals; Information systems; laparoscopic; Laparoscopy; long-term follow-up; Methods; Multivariate analysis; Nissen; Original; Patient outcomes; Patient satisfaction; Quality of life; Questionnaires; Response rates; Studies; Surgeons; Surgery; Systematic review; United States > US; laparoscopic; Nissen; quality of life; Gastroesophageal reflux disease; long-term follow-up
• ISSN: 0972-9941; 1998-3921
• DOI: 10.4103/jmas.JMAS_75_17

Introduction: Nissen fundoplication is the golden standard for surgical treatment of gastroesophageal reflux disease (GERD). Numerous studies report excellent short-term results. However, data regarding long-term quality of life are lacking. The aim of this study is to investigate the long-term quality of life after Nissen fundoplication in patients with GERD and to compare this with the short-term results. Patients and Methods: We retrospectively analysed all patients who underwent laparoscopic Nissen fundoplication for GERD between January 2004 and January 2016. All patients received a validated GERD-Health-Related Quality of Life questionnaire by mail to assess post-operative quality of life. Maximum quality of life is represented by a score of 75. Secondary outcome measures were complications and recurrence rate. Results: One hundred and seventy-five (77.1%) of the 227 operated patients returned the questionnaire. The median follow-up was 3.7 (0.1-10.3) years. Mean age was 51.6 (range 15-85) and 72 patients were male. We report an excellent quality of life with a median total score of 70 (range 2-75). Re-operation rate was 13.6% (23/169); the re-operation was due to recurrent reflux in 12 patients and due to persistent dysphagia in 11 patients. 91.3% of the re-operations were performed within the first 5 years after surgery. Mortality rate was zero. Conclusion: We report a large series of single-centre, single-surgeon laparoscopic Nissen fundoplication. Despite the re-operation rate of 13.6%, we found excellent long-term symptomatic outcome. There was no difference between short- and long-term results.