Background: Although around 30% of patients with gastroesophageal reflux disease (GERD) are insufficiently treated with medical therapy, only 1% opt for surgical therapy. One of the reasons behind this multifactorial phenomenon is the described adverse effect of long-term dysphagia or gastric bloating syndrome after surgical treatment. Aim of this study was to evaluate the most common side effects associated with anti-reflux surgery, as well as long-term outcomes in a large cohort of highly surgically standardized patients after laparoscopic Nissen fundoplication (LNF).
Methods: Out of a prospective patients' database including all patients that underwent anti-reflux surgery between 01/2003 and 01/2017 at our institution, 350 consecutive patients after highly standardized LNF were included in this study. A standardized interview was performed by one physician assessing postoperative gastrointestinal symptoms, proton pump inhibitor intake (PPI), GERD-Health-Related-Quality-of-Life (GERD-HRQL), Alimentary Satisfaction (AS), and patients' overall satisfaction.
Results: After a median follow-up of 4 years, persistent dysphagia (PD) after LNF was observed in 8 (2%) patients, while postoperative gas-bloat syndrome in 45 (12.7%) cases. Endoscopic dilatation was needed in 7 (2%) patients due to dysphagia, and 19 (5%) patients underwent revision surgery due to recurrence of GERD. The postoperative GERD-HRQL total score was significantly reduced (2 (IQR 0-4.3) vs. 19 (IQR 17-32); p < 0.000) and the median AS was 9/10. Heartburn relief was achieved in 83% of patients. Eighty-three percent of patients were free of PPI intake after follow-up, whereas 13% and 4% of the patients reported daily and irregular PPI use, respectively.
Conclusion: LNF is a safe and effective surgical procedure with low postoperative morbidity rates and efficient GERD-related symptom relief. PD does not represent a relevant clinical issue when LNF is performed in a surgical standardized way. These results should be the benchmark to which long-term outcomes of new surgical anti-reflux procedures are compared.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430753 | PMC |
| http://dx.doi.org/10.1007/s00464-018-6396-5 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Dysphagia development in heart failure patients: A scoping review.
Arch Gerontol Geriatr
December 2024
Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, Nagoya, Japan; Nutrition Therapy Support Center, Aichi Medical University Hospital, Aichi, Japan. Electronic address:
Objective: Dysphagia significantly affects older adults, particularly those with heart failure (HF). This scoping review aimed to delineate the development of dysphagia and its contributing factors in patients with HF.
Methods: We systematically searched MEDLINE, EMBASE, CINAHL, and CENTRAL databases up to September 2023, focusing on studies involving HF patients aged 60 and above, particularly those assessing post-hospitalization dysphagia.
Successful surgical management of esophageal leiomyoma presenting with gastroesophageal reflux disease symptoms: A case report.
Int J Surg Case Rep
December 2024
Gastroenterology Department, Al Ahli Hospital, Hebron 90200, Palestine.
Introduction: Esophageal leiomyoma is the most common benign submucosal mesenchymal tumor of the esophagus, typically asymptomatic but can cause symptoms such as dysphagia, chest pain, or regurgitation when large. Diagnosis is often incidental, confirmed by imaging techniques like computed tomography (CT) and endoscopic ultrasound (EUS), with surgical enucleation being the standard treatment.
Presentation Of Case: A 28-year-old male presented with a one-year history of persistent epigastric discomfort and gastroesophageal reflux disease (GERD) symptoms unresponsive to proton pump inhibitors.
Socioeconomic and Ethnic Disparities in Timing and Outcome of Interarytenoid Injection Augmentation.
Laryngoscope
December 2024
Division of Otolaryngology - Head and Neck Surgery, Phoenix Children's Hospital, Phoenix, Arizona, U.S.A.
Objectives: To investigate the relationship between social determinants of health and timeliness of management, adherence to follow-up, and outcomes of treatment with interarytenoid injection augmentation (IAIA).
Methods: Retrospective cohort study of all pediatric patients treated with IAIA at a large pediatric institution's multidisciplinary aerodigestive clinic between August 2022 and February 2024. Retrieved demographic factors, dates of referral, consultation, treatment, and follow-up, as well as objective measures of dysphagia and aspiration via videofluoroscopic swallow study (VFSS) reports, using dysphagia outcome and severity scale (DOSS) scores and the greatest unsafe thickness, or 'aspiration score'.
Cervical spinal cord injury following osteophyte excision for respiratory distress caused by diffuse idiopathic skeletal hyperostosis associated with ossification of posterior longitudinal ligament: a case report and literature review.
BMC Musculoskelet Disord
December 2024
Department of Orthopedic Surgery, Nara Medical University, 840 Shijo-cho Kashihara City, Nara, 6348522, Japan.
Background: Diffuse idiopathic skeletal hyperostosis (DISH) is a systemic non-inflammatory disorder characterized by enthesopathy and osteophyte formation. DISH can also cause several other symptoms. Limited range of motion (ROM) is the most common symptom; however, dysphagia and respiratory distress are clinically important symptoms.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!