Document Detail

Surgical outcome in gastro-esophageal reflux disease patients with inadequate response to proton pump inhibitors.
MedLine Citation:
PMID:  12728384     Owner:  NLM     Status:  MEDLINE    
Laparoscopic fundoplication (LF) has been shown to be effective in treatment of patients with gastro-esophageal reflux disease (GERD) requiring long-term medical therapy. Its effectiveness in patients with poor response to proton pump inhibitors (PPIs) has been questioned. We prospectively followed 445 patients with proven GERD inadequately controlled on PPI (up to 120 mg/day) and 274 GERD patients with good response to PPIs (20-120 mg/day) after LF. Patients in both groups underwent 24 h pH testing, esophageal manometry, symptom score evaluation, and quality-of-life (QOL) assessment (SF-36) before and at 6 months, 2 years, and 5 years after surgery. LF was associated with a marked improvement in percentage acid reflux, lower esophageal sphincter pressure, and symptom control in both groups of patients; however, the poor responders to PPIs also had a significant improvement in both physical and mental health component of the QOL assessment. Laparoscopic fundoplication provides an excellent symptom control for GERD patients, even those who have responded inadequately to large doses of PPIs. GERD patients who respond poorly to PPI therapy have significantly lowered physical and mental health QOL scores. Laparoscopic fundoplication in this group of patients leads to marked improvement of both components of QOL by 2 years after surgery.
M Anvari; C Allen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2003-05-06
Journal Detail:
Title:  Surgical endoscopy     Volume:  17     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2004-08-03     Completed Date:  2005-11-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1029-35     Citation Subset:  IM    
Department of Surgery, St. Joseph's Hospital, McMaster University, Hamilton, Canada.
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MeSH Terms
Follow-Up Studies
Fundoplication / methods
Gastroesophageal Reflux / drug therapy,  surgery*
Middle Aged
Proton Pumps / antagonists & inhibitors
Treatment Outcome
Reg. No./Substance:
0/Proton Pumps

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

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