Dynamics of quality of life improvement after floppy Nissen fundoplication for gastroesophageal reflux disease.

Abstract

IntroductionGastroesophageal reflux disease (GERD) has a negative impact on global quality of life (QOL) of patients. In patients affected by GERD, laparoscopic Nissen fundoplication is one of the most commonly performed laparoscopic procedures worldwide.AimTo prospectively analyze the dynamics of QOL as well as severity of pain in patients with GERD, before and after laparoscopic floppy Nissen fundoplication.Material and methodsThe study involved 104 consecutive patients operated on for GERD in whom laparoscopic floppy Nissen fundoplication was performed. QOL was assessed before surgery and 1, 3, 6, 12 and 24 months after. The following instruments were used: FACIT-G, FACIT-TS-G, GIQLI, GERD symptom scale.ResultsIt was found that symptom relief and quality of life improvement presented different dynamics in the postoperative course. Observations revealed relief of symptoms 1 month after surgery and improvement in QOL related to the gastrointestinal tract and pain 3 months after surgery. Global QOL increased significantly as late as 12 months after surgery.ConclusionsGastroesophageal reflux disease is a chronic disease of long duration, leading to impairment of quality of life. Patients, apart from typical symptoms of GERD, suffer from pain of significant severity. QOL improves significantly after surgery. Surgical treatment results in relief of GERD symptoms, which leads to gradual improvement of QOL.

Persistent dysphagia is a rare problem after laparoscopic Nissen fundoplication

“…Different questionnaires, such as SF-36 and GERD-HRQL, have been used to evaluate potential improvement in quality of life in patients after anti-reflux surgery as a quality measure of the operation itself. It has been shown that quality of life improvement is gradual: achieving symptom relief 1 month after surgery, improvement in GI quality of life in 3 months after surgery, and improvement in general quality of life in the first year after surgery [ 6 , 53 ]. We found a significant decrease in the GERD-HRQL total score (2 (IQR 0–4.3) vs. 19 (IQR 17–32); p < 0.000) after modified LNF, proving a substantial increase in quality of life, confirming previous outcomes.…”

Evaluation of Quality of Life: Functional Assessment of Chronic Illness Therapy after Thoracic Sympathectomy for Palmar Hyperhidrosis

“…The selection of this specific questionnaire results from its simplicity and transparency for patients and from our extensive experience with this QOL assessment tool. 18 The results of our study show a significant increase in all four domains of life (PWB, SWB, EWB, and FWB) after thoracic sympathectomy. The highest increase was observed in the functional domain, what can be comprehensible, as palmar hyperhidrosis mainly affects activities such as shaking hands or holding a pen, which are a part of patients' everyday functioning.…”

Study of the prevalence of gastroesophageal reflux symptoms and the role of each in relation to the GERD Impact Scale, based on a population of patients admitted for laparoscopic surgery compared to a control group.

“…Moreover, studies demonstrated that more than half of the patients had abnormal (> 4%) acid reflux in 24-h pH tests using PPI [ 19 ]. According to the literature and own experience, ARS seems to be the best way for long-term treatment of GERD and improving QoL [ 20 ].…”