J Neurogastroenterol Motil.  2019 Jul;25(3):394-402. 10.5056/jnm19059.

Multicenter Prospective Study of Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease in Korea

Affiliations
  • 1Department of Surgery, Korea University College of Medicine, Seoul, Korea.
  • 2Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea. jmpark@cau.ac.kr
  • 3Department of Surgery, The Catholic University of Korea College of Medicine, Incheon, Korea.
  • 4Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea.
  • 5Department of Surgery, Ajou University College of Medicine, Suwon, Korea.
  • 6Department of Surgery, Kosin University College of Medicine, Busan, Korea.
  • 7Department of Pharmacy, Kyungpook National University, Daegu, Korea.

Abstract

BACKGROUNDS/AIMS
This multicenter study aims to evaluate the effect and feasibility of anti-reflux surgery compared with medical treatment for gastroesophageal reflux disease (GERD).
METHODS
Patients with GERD who were undergoing medical treatment with proton pump inhibitors for more than 8 weeks and those who were scheduled to undergo anti-reflux surgery were enrolled. Efficacy of pre-operative medical treatment was evaluated retrospectively and effect of anti-reflux surgery was prospectively evaluated at 1 week and 3 months after surgery. Quality of life (QOL) was also investigated before and after surgery.
RESULTS
Between February and October 2018, 51 patients underwent laparoscopic Nissen fundoplication for treating GERD at 5 hospitals in Korea. Thirty-four patients (66.7%) showed poor proton pump inhibitor response. At 3 months after surgery, heartburn was completely resolved in 87.9% patients and partially improved in 9.1%. Acid regurgitation was completely resolved in 82.9% and partially improved in 11.4%. Atypical extraesophageal symptoms were completely controlled in 45.5% and partially controlled in 36.4%. GERD-related QOL scores at 1 week after surgery significantly improved compared with pre-operative scores. There was no difference in GERD-related QOL scores between 1 week and 3 months after surgery. General QOL measured with European QOL-5 dimensions and health-related QOL instrument with 8 items significantly improved after anti-reflux surgery. Satisfaction with treatment was significantly higher after surgery than before surgery (72.5% vs 11.8%, P < 0.001).
CONCLUSION
Anti-reflux surgery improved GERD symptoms and QOL in patients. Anti-reflux surgery is an effective treatment option compared with medical treatment for GERD patients selected for surgical treatment.

Keyword

Fundoplication; Gastroesophageal reflux; Laparoscopy; Quality of life

MeSH Terms

Fundoplication*
Gastroesophageal Reflux*
Heartburn
Humans
Korea*
Laparoscopy
Prospective Studies*
Proton Pump Inhibitors
Proton Pumps
Quality of Life
Retrospective Studies
Proton Pump Inhibitors
Proton Pumps
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