INTRODUCTION: Laparoscopic Nissen fundoplication is accepted as a standard and effective therapy for refractory GERD; however, controversy exists regarding the eficacy of Nissen fundoplication in obese patients. We report on the results of symptomatic outcomes of a series of obese and non-obese patients with GERD receiving laparoscopic Nissen fundoplication.
METHODS: A single center retrospective review of initial adult laparoscopic Nissen fundoplication from November 2001 through May 2008. Weight, QOLRAD questionnaire (Quality of Life in Reflux and Dyspepsia), antacid use and symptoms were recorded pre-operatively, and at 3 months and 12 months post-operatively. An antacid use index was constructed based on the type and multiplicity of use. A symptom score index was determined based on the presence of: heartburn, regurgitation, dysphagia, bloating, epigastric pain and/or respiratory symptoms. Statistical analysis of groups was performed using two-tailed t-test.
RESULTS: 289 patients (F=169, M=120), with a mean age of 49.5 ± 13.6 years (20 – 83 years) underwent initial laparoscopic Nissen fundoplication for GERD. Length of hospital stay (LOS) was 1.14 days (STD 0.53). There was no operative mortality.
Reduction in BMI, antacid use and symptoms, and improvement in QOLRAD score at twelve months was statistically significant. However, there were no statistically significant difference in the response of patients with BMI 40.
CONCLUSIONS: Significant improvment in outcomes of Laparoscopic Nissen fundoplication were demonstrated for symptoms score, antacid use and QOLRAD. However, there was not a significant difference in the symptomatic improvement following laparoscopic Nissen fundoplication between obese and non-obese patients.
Program Number: P319