Document Detail


Laparoscopic anti-reflux surgery is effective in obese patients with gastro-oesophageal reflux disease.
MedLine Citation:
PMID:  17959008     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Obesity has long been regarded as a risk factor for the development of gastro-oesophageal reflux disease (GORD). It has been claimed that surgical efficacy of laparoscopic anti-reflux operations is decreased in obese patients. The aim of this study was to assess whether laparoscopic anti-reflux surgery is effective in obese patients with GORD compared to non-obese patients. PATIENTS AND METHODS: A total of 366 patients (mean age 44 years; range, 12-86 years) underwent laparoscopic anti-reflux surgery between 1997-2003. Of these, 74 patients were considered obese; 58 patients had a body mass index (BMI) of 30-34 kg/m(2) and 16 were classified as morbidly obese with a BMI >or= 35 kg/m(2). Pre-operative symptomatic scoring, indications for surgery, pH studies, operative times and complications were compared between obese and non-obese patients. Symptomatic outcome and Visick score between the two groups were assessed at 6 weeks, 6 months and 1 year following surgery. RESULTS: Failure of medical treatment was the main reason for surgery in all groups. Operative time was longer in obese patients (mean time 93 min compared to 81 min; P = 0.0007), the main difficulty being gaining access because of their body habitus. All groups found the procedure to be effective in symptomatic outcome, 91% of obese patients compared to 92% of non-obese patients scored Visick I or II at 6 weeks' postoperatively. Similar Visick scoring was shown between the two groups at 6 months and 1 year, and in the morbidly obese group. CONCLUSIONS: The outcome of laparoscopic anti-reflux surgery is similar between obese and non-obese patients with no trend towards a worse outcome in the obese or morbidly obese. Obesity should not be seen as a contra-indication, although it may be more technically challenging in this group of patients. Good results can be achieved in obese patients.
Authors:
Vivien V Ng; Michael I Booth; Jane J Stratford; Linda Jones; J Sohanpal; Thomas C B Dehn
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of the Royal College of Surgeons of England     Volume:  89     ISSN:  1478-7083     ISO Abbreviation:  Ann R Coll Surg Engl     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-25     Completed Date:  2007-11-29     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7506860     Medline TA:  Ann R Coll Surg Engl     Country:  England    
Other Details:
Languages:  eng     Pagination:  696-702     Citation Subset:  IM    
Affiliation:
Department of General Surgery and GI Physiology, Royal Berkshire Hospital, Reading, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Body Mass Index
Child
Female
Gastroesophageal Reflux / surgery*
Humans
Laparoscopy / methods*
Length of Stay
Male
Middle Aged
Obesity / complications*
Retrospective Studies
Treatment Outcome
Comments/Corrections

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