Laparoscopic fundoplication: A model for assessing new technology in surgical procedures

Relationship between subjective and objective outcome measures after Heller myotomy and Dor fundoplication for achalasia

“…It is responsive to medical and surgical treatment of GERD. In assessing laparoscopic antireflux surgery, we previously found an improvement in median GERD-HRQL from 18 (range, 14-26) preop to 0 (range, 0-2) 2 years postop [9]. In the current study, we found that patients with achalasia had a preop GERD-HRQL score of 13.5 (range, 6.3-22.5), which improved significantly to 2 (range, 0-5) postop.…”

“…Of the 20 patients with some heartburn after surgery, 13 patients rated their heartburn as mild, six as ''moderate,'' and one as ''severe.'' Patients reporting moderate or severe postop heartburn had a GERD-HRQL of 10.5 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) compared to 1 (0-3.5) for those with no or mild heartburn (p = 0.004). Heartburn score correlated well with GERD-HRQL score (SpearmanÕs rho = 0.79, p = 0.000).…”

Comparison of patient-centered outcomes after laparoscopic Nissen fundoplication for gastroesophageal reflux disease or paraesophageal hernia

“…We have demonstrated in this study that GERD patients have significantly improved general quality of life in both the physical and mental component domains, confirming prior studies [2,3,18]. Furthermore, these scores are increased significantly above the population norm (SF-12 population mean = 50), illustrating the benefit of laparoscopic fundoplication for this indication.…”

“…In patients with symptomatic GERD, laparoscopic fundoplication has been shown to provide excellent long-term patient-centered outcomes and symptom control [2][3][4][5][6]. The outcomes of laparoscopic PEH repair have been more variable [4,8,9,11,[14][15][16], and the routine application of Nissen fundoplication in this patient population has not been definitively studied.…”

Psychometric documentation of a quality-of-life questionnaire for patients undergoing antireflux surgery (QOLARS)

“…When physiologic endpoints have been used, it has repeatedly been shown to increase resting LES pressure and decrease esophageal exposure to acid [5,11,14]. Objective measurment of physiologic outcome parameters does not always correlate with patient satisfaction or with improvement of QoL and symptomatology [7,16]. With increasing recognition that physiologic measures alone may provide an inadequate basis for clinical decision making, QoL has become more important.…”