Document Detail


Antireflux surgery for non-erosive and erosive reflux disease in community practice.
MedLine Citation:
PMID:  16907894     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Antireflux surgery has been mainly evaluated in tertiary referral centres. Data regarding post-operative outcome in non-erosive reflux disease are lacking. AIM: To assess long-term outcome after antireflux surgery performed in a community practice setting. METHODS: We selected consecutively 60 non-erosive reflux disease patients and 61 erosive oesophagitis patients with symptomatic gastro-oesophageal reflux disease. After surgery, each subject answered a validated disease-specific health-related quality of life questionnaire and another questionnaire focusing on symptoms, late morbidity and drug use. RESULTS: After a 43-month median follow-up, an excellent outcome was reported by less than two-thirds of patients. Quality of life scores were lower in the non-erosive reflux disease group, especially in female patients. Non-erosive reflux disease patients reported more daily symptoms and more reflux-related symptoms (P = 0.04). Proton-pump inhibitor use was higher in non-erosive reflux disease patients (P < 0.005). Multivariate analysis identified four independent predictive factors associated with better outcome, namely male gender, abnormal preoperative acid exposure, a long duration of symptoms and surgical expertise. CONCLUSIONS: In community practice, the results of antireflux surgery are inferior to those reported by tertiary centres. Outcome seems poorer in non-erosive reflux disease especially in female patients. Nearly one-third of the non-erosive reflux disease patients continue to take proton-pump inhibitors. These results highlight the need for careful selection of patients before antireflux surgery.
Authors:
R Thibault; E Coron; V Sébille; S Sacher-Huvelin; S Bruley des Varannes; J Gournay; J P Galmiche
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Alimentary pharmacology & therapeutics     Volume:  24     ISSN:  0269-2813     ISO Abbreviation:  Aliment. Pharmacol. Ther.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-15     Completed Date:  2007-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8707234     Medline TA:  Aliment Pharmacol Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  621-32     Citation Subset:  IM    
Affiliation:
Department of Gastroenterology, Hepatology and Nutritional Support, Institut des Maladies de l'Appareil Digestif, University Hospital, Nantes, France.
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MeSH Terms
Descriptor/Qualifier:
Antacids / therapeutic use
Endoscopy, Gastrointestinal
Female
Gastroesophageal Reflux / surgery*
Histamine H2 Antagonists / therapeutic use
Humans
Hydrogen-Ion Concentration
Male
Manometry
Middle Aged
Postoperative Care / methods
Preoperative Care / methods
Quality of Life
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antacids; 0/Histamine H2 Antagonists

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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