| Medical comorbidities should not deter the application of laparoscopic fundoplication. | |
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MedLine Citation:
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PMID: 20552292 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Laparoscopic Nissen fundoplication offers significant improvement in gastroesophageal reflux disease (GERD) symptom severity and frequency. This study was undertaken to determine the impact of preoperative medical comorbidities on the outcome and satisfaction of patients undergoing fundoplication for GERD. METHODS: Prior to fundoplication, patients underwent esophageal motility testing and 24-h pH monitoring. Before and after fundoplication, the frequency and severity of reflux symptoms were scored using a Likert scale. Medical comorbidities were classified by organ systems, and patients were assigned points corresponding to the number of medical comorbidities they had. In addition, all patients were assigned Charlson comorbidity index (CCI) scores according to the medical comorbidities they had. A medical comorbidity was defined as a preexisting medical condition, not related to GERD, for which the patient was receiving treatment. Analyses were then conducted to determine the impact of medical comorbidities as well as CCI score on overall outcome, symptom improvement, and satisfaction. RESULTS: Six hundred and ninety-six patients underwent fundoplication: 538 patients had no medical comorbidities and 158 patients had one or more medical comorbidities. Preoperatively, there were no differences in symptom severity and frequency scores between patients with or without medical comorbidities. Postoperatively, all patients had improvement in their symptom severity and frequency scores. There were no differences in postoperative symptom scores between the patients with medical comorbidities and those without. The majority of patients were satisfied with their overall outcome; there was no relationship between the number of medical comorbidities and satisfaction scores. These findings were mirrored when patients' CCI scores were compared with satisfaction, overall outcome, and symptom improvement. CONCLUSION: These results promote further application of laparoscopic Nissen fundoplication, even for patients with medical comorbidities. |
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Authors:
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Farhaad Golkar; Connor Morton; Sharona Ross; Michelle Vice; Demitri Arnaoutakis; Sujat Dahal; Jonathan Hernandez; Alexander Rosemurgy |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-06-15 |
Journal Detail:
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Title: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Volume: 14 ISSN: 1873-4626 ISO Abbreviation: J. Gastrointest. Surg. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-26 Completed Date: 2010-11-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1214-9 Citation Subset: IM |
Affiliation:
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University of South Florida and Tampa General Hospital Digestive Disorders Center, Tampa, FL, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiovascular Diseases
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complications* Female Follow-Up Studies Fundoplication / methods* Gastroesophageal Reflux / complications, physiopathology, surgery* Gastrointestinal Motility / physiology Humans Laparoscopy Male Manometry Mental Disorders / complications* Middle Aged Musculoskeletal Diseases / complications* Nervous System Diseases / complications* Patient Satisfaction Pressure Prospective Studies Respiratory Tract Diseases / complications* Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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