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Ann Surg. Mar 1999; 229(3): 331–336.
PMCID: PMC1191697

Improvement in quality of life measures after laparoscopic antireflux surgery.

Abstract

OBJECTIVE: To determine if patients with gastroesophageal reflux "well controlled medically" had a different quality of life from those with residual symptoms receiving aggressive medical therapy, and to determine whether laparoscopic antireflux surgery significantly altered quality of life in patients with gastroesophageal reflux. SUMMARY BACKGROUND DATA: Clinical determinants of outcome may not adequately reflect the full impact of therapy. The medical outcomes study short form (SF-36) is a well-validated questionnaire that assays eight specific health concepts in three general fields. It may provide a more sensitive tool for judging the success of antireflux therapy. METHODS: A total of 345 patients undergoing laparoscopic antireflux surgery completed at least one questionnaire during the study period. Preoperative questionnaires were completed by 290 patients, 223 completed a questionnaire 6 weeks after surgery, and 50 completed the same questionnaire 1 year after surgery. A subgroup of 70 patients was divided before surgery into two groups on the basis of their response to standard medical therapy. RESULTS: Preoperative scores were extremely low. All eight SF-36 health categories improved significantly 6 weeks and 1 year after surgery. In the 70-patient subgroup, 53 patients (76%) underwent laparoscopic antireflux surgery because of symptoms refractory to medical therapy and 17 patients (24%) reported that their symptoms were well controlled but elected to have surgery because they wished to be medication-free. The preoperative quality of life scores of these two patient groups were equivalent in all but one category. Postoperative scores were significantly improved in all categories and indistinguishable between the two groups. CONCLUSIONS: Laparoscopic antireflux surgery is an effective therapy for patients with gastroesophageal reflux and may be more effective than medical therapy at improving quality of life.

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  • Spechler SJ. Comparison of medical and surgical therapy for complicated gastroesophageal reflux disease in veterans. The Department of Veterans Affairs Gastroesophageal Reflux Disease Study Group. N Engl J Med. 1992 Mar 19;326(12):786–792. [PubMed]
  • Trus TL, Laycock WS, Branum G, Waring JP, Mauren S, Hunter JG. Intermediate follow-up of laparoscopic antireflux surgery. Am J Surg. 1996 Jan;171(1):32–35. [PubMed]
  • Hunter JG, Trus TL, Branum GD, Waring JP, Wood WC. A physiologic approach to laparoscopic fundoplication for gastroesophageal reflux disease. Ann Surg. 1996 Jun;223(6):673–687. [PMC free article] [PubMed]
  • DeVault KR. Current management of gastroesophageal reflux disease. Gastroenterologist. 1996 Mar;4(1):24–32. [PubMed]
  • Ware JE, Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992 Jun;30(6):473–483. [PubMed]
  • McHorney CA, Ware JE, Jr, Raczek AE. The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993 Mar;31(3):247–263. [PubMed]
  • McHorney CA, Ware JE, Jr, Lu JF, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): III. Tests of data quality, scaling assumptions, and reliability across diverse patient groups. Med Care. 1994 Jan;32(1):40–66. [PubMed]
  • McHorney CA, Ware JE, Jr, Rogers W, Raczek AE, Lu JF. The validity and relative precision of MOS short- and long-form health status scales and Dartmouth COOP charts. Results from the Medical Outcomes Study. Med Care. 1992 May;30(5 Suppl):MS253–MS265. [PubMed]
  • Garratt AM, Ruta DA, Abdalla MI, Buckingham JK, Russell IT. The SF36 health survey questionnaire: an outcome measure suitable for routine use within the NHS? BMJ. 1993 May 29;306(6890):1440–1444. [PMC free article] [PubMed]
  • Garratt AM, Ruta DA, Abdalla MI, Russell IT. SF 36 health survey questionnaire: II. Responsiveness to changes in health status in four common clinical conditions. Qual Health Care. 1994 Dec;3(4):186–192. [PMC free article] [PubMed]
  • Ruta DA, Abdalla MI, Garratt AM, Coutts A, Russell IT. SF 36 health survey questionnaire: I. Reliability in two patient based studies. Qual Health Care. 1994 Dec;3(4):180–185. [PMC free article] [PubMed]
  • Waring JP, Hunter JG, Oddsdottir M, Wo J, Katz E. The preoperative evaluation of patients considered for laparoscopic antireflux surgery. Am J Gastroenterol. 1995 Jan;90(1):35–38. [PubMed]
  • Richardson WS, Trus TL, Hunter JG. Laparoscopic antireflux surgery. Surg Clin North Am. 1996 Jun;76(3):437–450. [PubMed]
  • DeVault KR, Castell DO. Guidelines for the diagnosis and treatment of gastroesophageal reflux disease. Practice Parameters Committee of the American College of Gastroenterology. Arch Intern Med. 1995 Nov 13;155(20):2165–2173. [PubMed]
  • Pope CE., 2nd The quality of life following antireflux surgery. World J Surg. 1992 Mar-Apr;16(2):355–358. [PubMed]
  • Glise H, Hallerbäck B, Johansson B. Quality of Life assessments in the evaluation of gastroesophageal reflux and peptic ulcer disease before, during and after treatment. Scand J Gastroenterol Suppl. 1995;208:133–135. [PubMed]
  • Glise H, Hallerbäck B, Johansson B. Quality-of-life assessments in evaluation of laparoscopic Rosetti fundoplication. Surg Endosc. 1995 Feb;9(2):183–189. [PubMed]
  • Velanovich V, Vallance SR, Gusz JR, Tapia FV, Harkabus MA. Quality of life scale for gastroesophageal reflux disease. J Am Coll Surg. 1996 Sep;183(3):217–224. [PubMed]
  • Velanovich V. Comparison of generic (SF-36) vs. disease-specific (GERD-HRQL) quality-of-life scales for gastroesophageal reflux disease. J Gastrointest Surg. 1998 Mar-Apr;2(2):141–145. [PubMed]
  • Irvine EJ. Quality of Life in inflammatory bowel disease: biases and other factors affecting scores. Scand J Gastroenterol Suppl. 1995;208:136–140. [PubMed]
  • Wiklund I. Aspects of quality of life in gastrointestinal disease: some methodological issues. Scand J Gastroenterol Suppl. 1995;208:129–132. [PubMed]
  • McCarthy DM. Quality of Life: a critical assessment. Scand J Gastroenterol Suppl. 1995;208:141–146. [PubMed]
  • Currie IC, Wilson YG, Baird RN, Lamont PM. Treatment of intermittent claudication: the impact on quality of life. Eur J Vasc Endovasc Surg. 1995 Oct;10(3):356–361. [PubMed]
  • Talley NJ, Weaver AL, Zinsmeister AR. Impact of functional dyspepsia on quality of life. Dig Dis Sci. 1995 Mar;40(3):584–589. [PubMed]
  • Stewart AL, Greenfield S, Hays RD, Wells K, Rogers WH, Berry SD, McGlynn EA, Ware JE., Jr Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. JAMA. 1989 Aug 18;262(7):907–913. [PubMed]
  • Blumenthal D. Part 1: Quality of care--what is it? N Engl J Med. 1996 Sep 19;335(12):891–894. [PubMed]
  • Brook RH, McGlynn EA, Cleary PD. Quality of health care. Part 2: measuring quality of care. N Engl J Med. 1996 Sep 26;335(13):966–970. [PubMed]
  • Chassin MR. Quality of health care. Part 3: improving the quality of care. N Engl J Med. 1996 Oct 3;335(14):1060–1063. [PubMed]
  • Blumenthal D. Quality of health care. Part 4: The origins of the quality-of-care debate. N Engl J Med. 1996 Oct 10;335(15):1146–1149. [PubMed]
  • Berwick DM. Quality of health care. Part 5: Payment by capitation and the quality of care. N Engl J Med. 1996 Oct 17;335(16):1227–1231. [PubMed]
  • Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med. 1993 Apr 15;118(8):622–629. [PubMed]
  • Mant JW, Jenkinson C, Murphy MF, Clipsham K, Marshall P, Vessey MP. Use of the Short Form-36 to detect the influence of upper gastrointestinal disease on self-reported health status. Qual Life Res. 1998 Apr;7(3):221–226. [PubMed]

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