Surgical Outcomes and Quality of Life After Anti-reflux Surgery

Abstract Background: Gastro esophageal reflux disease (GERD) has an increasing incidence, ranging from 10% to 20% in western countries. Anti-reflux surgery is indicated in patients that cannot sustain a long-term proton pump inhibitor (PPI) treatment, those in whom it is not effective, and those who associate a hiatal hernia (HH). The aim of this study is to evaluate anti-reflux surgery results in our institution, and asses the patient’s postoperative quality of life. Methods: We analyzed all patients submitted to laparoscopic anti-reflux surgery at Médica Uruguaya Corporación de Asistencia Médica (MUCAM) over the last 13 years. A quality-of-life (QOL) questionnaire was performed to evaluate surgical outcomes. Results: 103 patients were included, 80% were female and the average age was 59 years. 70% presented with GERD symptoms and 65% had a type III or IV HH. A Nissen fundoplication was performed in 98% of patients and a Toupet fundoplication in the remaining 2%. There was no mortality or need for conversion. Five patients had an early stenosis; four required reoperation and one an endoscopic dilation. Six patients required a late reoperation. 92% of patients answered the QOL questionnaire. 21% of respondents presented postoperative dysphagia and 37% are currently under PPI treatment, but these only affects the QOL of 1% and 3% of patients, respectively. 91% of those surveyed are satisfied with their current situation. Discussion: Our results coincide with those presented in the literature, showing that anti-reflux surgery is a safe procedure, that has a high satisfaction rate among patients.