Influence of psychopathological changes on quality of life after laparoscopic fundoplication for the treatment of gastroesophageal reflux

Abstract

There are references in medical literature to the influence of psychopathological changes and their negative impact on the results of laparoscopic fundoplication. The objective of this study is to analyze the influence of psychological changes, as assessed by the General Health Questionnaire-28 (GHQ-28), on patients undergoing surgery for gastroesophageal reflux. This is a prospective study in a series of 103 consecutive patients (62 males and 41 females with a mean age of 40 years) undergoing laparoscopic fundoplication. In addition to functional studies, patients completed the SF-36, Gastrointestinal Quality of Life Index, and GHQ-28 before surgery. Functional tests and questionnaires were repeated 6 months after surgery. Patients were also questioned about their degree of satisfaction. Postoperative results of patients with a normal GHQ-28 and patients showing psychopathological changes as defined by the GHQ-28 questionnaire before surgery were compared. Overall, all patients experienced an improvement in their quality of life. Forty-one patients showed a pathological result in the preoperative GHQ-28 questionnaire. No differences were found in functional results and degree of satisfaction with surgery between patients with normal and pathological results in the preoperative GHQ-28 questionnaire. However, patients with a pathological result in the preoperative GHQ-28 had poorer results in all domains of the postoperative Gastrointestinal Quality of Life Index and SF36 quality of life questionnaires as compared to patients with a normal preoperative GHQ-28 questionnaire. Patients with pathological results in the preoperative GHQ-28 had poorer results in terms of postoperative quality of life despite having normal postoperative physiological studies; this decreased quality of life did not have an impact on the degree of satisfaction with surgery performed. The GHQ-28 does not therefore appear to serve as a predictor of postoperative satisfaction.

Nissen versus Dor Fundoplication for Treatment of Gastroesophageal Reflux Disease: A Blinded Randomized Clinical Trial

“…The correlation between patients’ satisfaction and postoperative QoL scores is a point of controversy in the literature. Good concordances with QoL questionnaires or essential parts of it are described as well as a lack of correlation [25,26,29]. Furthermore, a most recent prospective observational study showed that females were less satisfied with the outcome after fundoplication.…”

Quality of Life after Laparoscopic Cholecystectomy for Biliary Dyskinesia in the Pediatric Population: A Pilot Study

“…15 Evidence in the literature also suggests that psychosocial and psychopathological patient characteristics can influence patient satisfaction and perceived quality of life after gastrointestinal surgery regardless of clinical outcome. 16 The healthrelated quality of life of pediatric patients after laparoscopic cholecystectomy has not yet been examined. For these reasons, we selected the CHQ-PF28, which is a valid and reliable tool to measure psychosocial and general health in children, and a modified GIQLI to examine gastrointestinal symptoms and gastrointestinal-related quality of life.…”