• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Univariate and Multivariate Analyses of Preoperative Factors Influencing Symptomatic Outcomes of Transoral Fundoplication

Reginald CW Bell, MD, FACS, Mark A Fox, MD, FACS, William E Barnes, MD, FACS, Peter G Mavrelis, MD, Robert W Sewell, MD, FACS, Bart J Carter, MD, FACS, Glenn M Ihde, MD, Karim S Trad, MD, FACS, David Dargis, DO, Kevin M Hoddinott, MD, FACS, Katherine D Freeman, MSN, NP, Tanja Gunsberger, DO, Mark G Hausmann, MD, FACS, Brian DaCosta Gill, MD, FACS, Erik Wilson, MD, FACS. SurgOne Foregut Institute, Englewood, Colorado; Crossville Medical Group, PA, Crossville, Tennessee; Livingston Hospital and Healthcare Services, Inc. CAH, Salem, Kentucky; Internal Medicine Associates, Merrillville, Indiana.

OBJECTIVE: Identification of preoperative factors that predict symptomatic outcomes of transoral fundoplication (TF) in chronic gastroesophageal reflux disease (GERD) patients refractory to proton pump inhibitor (PPI) therapy.

METHODS: Univariate and multivariate logistic regression analyses were performed on data from 158 consecutive patients who underwent TF with the EsophyX device between January 2010 and June 2012 in 14 community centers. Variables included age, gender, body mass index, GERD duration, PPI therapy duration, presence of hiatal hernia , esophagitis, Hill grade, quality of life scores (QOL) on PPIs, % total time pH < 4 and DeMeester score on 48-hour pH monitoring. Covariates with P values ≤ 0.25 on univariate analyses underwent backwards stepwise multivariate regression analyses. P value ≤ 0.05 was considered significant. Symptomatic outcomes were grouped as follows: (1) Successful, completely off PPIs and ≥ 50% reduction of a Gastroesophageal Reflux Disease Health-related Quality of Life (GERD-HRQL) score or normalization of Reflux Symptom Index (RSI) score (≤ 13); (2) Partially successful, on PPIs and ≥ 50% reduction in GERD-HRQL score or normalization of RSI score; (3) Poor, reoperation or < 50% reduction in GERD-HRQL or abnormal RSI score. Analyses were performed separately on patients with typical and atypical symptoms before TF.

RESULTS:  All patients suffered from typical GERD symptoms. Additionally, 78% (124/158) of patients suffered from atypical symptoms (RSI score > 13). Median age was 59 (range 19-80) years; 71% (112/158) were female. Six percent (10/158) with recurrent GERD symptoms refractory to PPI therapy underwent revisional procedure (9 laparoscopic Nissen, 1 TF). Globally, at a median follow-up of 22 (10-43) months, 70% of patients (111/158) had successful or partially successful outcomes; 30% (47/158) had poor outcomes. Seventy-seven percent (121/158) of patients were off daily PPIs; 70% (110/158) were completely off PPIs. The median GERD-HRQL score improved from 28 (10-50) before TF on PPIs to 5 (0-45), P < 0.001. In 124 patients with atypical symptoms, the median RSI score improved from 26 (14-45) before TIF on PPIs to 5.5 (0-41), P < 0.001.
In patients with typical symptoms, univariate analyses revealed 4 preoperative factors predictive of successful outcomes: age ≥ 50 [odds ratio (OR) = 2.4; 95% confidence interval (CI) = 1.2- 4.8, P = 0.014]; GERD-HRQL score ≥ 15 on PPIs (OR=6.0, CI = 1.2-29.4, P = 0.026, RSI score ≥ 13 on PPIs (OR = 2.4, CI = 1.1-5.2, P = 0.027) and GERSS score ≥ 18 on PPIs (OR = 2.6, CI = 1.2-5.8, P = 0.018). Female gender approached closely the significance level (OR = 2.0, CI = 1.0-4.0, P = 0.053). Age and GERD-HRQL score on PPIs remained significant predictors at the multivariate level. In patients with atypical symptoms, the only factor associated with successful outcomes was GERD-HRQL score ≥ 15 on PPIs (OR=9.9, CI = 0.9-4.6, P = 0.036).

CONCLUSIONS: Elevated preoperative QOL scores and age ≥ 50 were most closely associated with successful outcome of TF in this analysis; objective measures were not. Further studies are needed to confirm these findings.

View Poster

63

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2014 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons