Document Detail


Medical comorbidities should not deter the application of laparoscopic fundoplication.
MedLine Citation:
PMID:  20552292     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Farhaad Golkar; Connor Morton; Sharona Ross; Michelle Vice; Demitri Arnaoutakis; Sujat Dahal; Jonathan Hernandez; Alexander Rosemurgy
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-06-15
Journal Detail:
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:
Created Date:  2010-07-26     Completed Date:  2010-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1214-9     Citation Subset:  IM    
Affiliation:
University of South Florida and Tampa General Hospital Digestive Disorders Center, Tampa, FL, USA.
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Diseases / 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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