Late Outcomes After Laparoscopic Surgery for Gastroesophageal Reflux

HYPOTHESIS: Patients still have symptoms following laparoscopic antireflux surgery and require ongoing treatment. DESIGN: Mailed survey. SETTING: Academic tertiary care center. PATIENTS: Of 247 consecutive adults, 197 (80% response) who underwent laparoscopic fundoplication for gastroesophageal reflux disease in the prior 1 to 5 years. MAIN OUTCOME MEASURES: Gastrointestinal symptoms (frequency and bother), actions taken to treat these symptoms (medications and dietary and lifestyle changes), and assessment of surgery. RESULTS: The mean age of the respondents was 51.1 years, and 52% were men. The median time since surgery was 2.6 years. Overall, 28% reported typical reflux symptoms (heartburn or regurgitation), but only 5% were bothered "a lot" or "terribly" by them. While 65% reported other gastrointestinal symptoms (bloating or dysphagia) that may be related to gastroesophageal reflux disease or to surgery, only 19% were bothered a lot or terribly by them. About half of the respondents reported taking at least 1 of the following actions for their symptoms: 6% take frequent over-the-counter medications, 13% take daily prescription acid-reducing medications, 41% make lifestyle changes (eg, eating smaller meals), and 44% avoid certain foods (eg, carbonated beverages). Nevertheless, 90% believed their surgery was working well. CONCLUSIONS: In 1 to 5 years after laparoscopic antireflux surgery, many patients report gastrointestinal symptoms and take action to control these symptoms. Most, however, believe their surgical treatment is working well.