Multicenter Prospective Study of Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease in Korea
- Author:
Sungsoo PARK
1
;
Joong Min PARK
;
Jin Jo KIM
;
In Seob LEE
;
Sang Uk HAN
;
Kyung Won SEO
;
Jin Won KWON
Author Information
- Publication Type:Multicenter Study
- Keywords: Fundoplication; Gastroesophageal reflux; Laparoscopy; Quality of life
- MeSH: Fundoplication; Gastroesophageal Reflux; Heartburn; Humans; Korea; Laparoscopy; Prospective Studies; Proton Pump Inhibitors; Proton Pumps; Quality of Life; Retrospective Studies
- From:Journal of Neurogastroenterology and Motility 2019;25(3):394-402
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUNDS/AIMS: This multicenter study aims to evaluate the effect and feasibility of anti-reflux surgery compared with medical treatment for gastroesophageal reflux disease (GERD). METHODS: Patients with GERD who were undergoing medical treatment with proton pump inhibitors for more than 8 weeks and those who were scheduled to undergo anti-reflux surgery were enrolled. Efficacy of pre-operative medical treatment was evaluated retrospectively and effect of anti-reflux surgery was prospectively evaluated at 1 week and 3 months after surgery. Quality of life (QOL) was also investigated before and after surgery. RESULTS: Between February and October 2018, 51 patients underwent laparoscopic Nissen fundoplication for treating GERD at 5 hospitals in Korea. Thirty-four patients (66.7%) showed poor proton pump inhibitor response. At 3 months after surgery, heartburn was completely resolved in 87.9% patients and partially improved in 9.1%. Acid regurgitation was completely resolved in 82.9% and partially improved in 11.4%. Atypical extraesophageal symptoms were completely controlled in 45.5% and partially controlled in 36.4%. GERD-related QOL scores at 1 week after surgery significantly improved compared with pre-operative scores. There was no difference in GERD-related QOL scores between 1 week and 3 months after surgery. General QOL measured with European QOL-5 dimensions and health-related QOL instrument with 8 items significantly improved after anti-reflux surgery. Satisfaction with treatment was significantly higher after surgery than before surgery (72.5% vs 11.8%, P < 0.001). CONCLUSION: Anti-reflux surgery improved GERD symptoms and QOL in patients. Anti-reflux surgery is an effective treatment option compared with medical treatment for GERD patients selected for surgical treatment.
