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Patient Reported Outcomes Following Laparoscopic Surgery for Benign Upper Gastrointestinal Disease

View Article: PubMed Central - PubMed

ABSTRACT

Patient reported quality of life (QOL) outcomes are important tools for measuring the success of surgical intervention. This is of particular relevance in benign disease when surgery is specifically indicated primarily to treat symptoms and improve QOL. In upper gastrointestinal disease, common conditions such as achalasia, gastro-oeosphageal reflux disease and para-oesophageal hernias can have a significant impact on patient's quality of life. The aim of this study was to compare QOL scores before and after surgery for these conditions, and to assess patient satisfaction.

Patients who underwent laparoscopic paraoesophageal hernia (POH) repair, laparoscopic cardiomyotomy or laparoscopic fundoplication over a 7 year period (2006-2013) by one surgeon were asked to assess their symptoms before and after surgery using the Gastro-oesophageal Reflux Disease-Health Related Quality-Of-Life (GORD-HRQOL) Score and The Royal Adelaide Dysphagia (RAD) Score, and to rate their satisfaction.

All procedures were carried out electively, with no 30- day mortality, and an absence of any major peri-operative morbidity.

Responses were received from 121 patients (68 female and 53 male). This comprised of 34 POH repairs, 39 cardiomyotomies and 48 fundoplications.

Median GORD scores improved significantly for all groups; POH 20.5 to 2, (p<0.0001), Fundoplication 24.5 to 6.5 (p<0.0001), and Cardiomyotomy 21 to 10 (p=0.0008).

Dysphagia scores improved significantly for Cardiomyotomy, 7.5 to 30 (p<0.0001), and POH, 25 to 40.5 (p=0.044), but not with Fundoplication 45 to 35.25 (p =0.17).

64% of patients were ‘satisfied’ or ‘very satisfied’ with their current condition. 77% were 'satisfied’ or ‘very satisfied’ with the procedure itself.

This study has shown that there is a high rate of patient satisfaction following laparoscopic surgery for benign upper GI disease.

No MeSH data available.


Related in: MedlinePlus

Incidence of GORD symptoms in pre (series 1) and post (series 2) treatment patients.
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Figure 0001: Incidence of GORD symptoms in pre (series 1) and post (series 2) treatment patients.

Mentions: This study using patient reported outcome measures has shown that symptoms of dysphagia and GORD can be significantly improved following laparoscopic surgery for achalasia and POH. (Figures 1&2). The fundoplication group, as expected, showed a significant improvement in GORD scores but a non-significant worsening of dysphagia scores. Satisfaction scores were also high across all the groups following surgery but lowest in the fundoplication group, possibly as a result of some patients having a degree of dysphagia. This may also help to explain why the response rate was lower in this group. However, the overall response rate in this study is in keeping with what would be expected from similar studies. It is accepted that the lower the response rate, the lower the effective sample size and the greater the risk of bias.15


Patient Reported Outcomes Following Laparoscopic Surgery for Benign Upper Gastrointestinal Disease
Incidence of GORD symptoms in pre (series 1) and post (series 2) treatment patients.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4920492&req=5

Figure 0001: Incidence of GORD symptoms in pre (series 1) and post (series 2) treatment patients.
Mentions: This study using patient reported outcome measures has shown that symptoms of dysphagia and GORD can be significantly improved following laparoscopic surgery for achalasia and POH. (Figures 1&2). The fundoplication group, as expected, showed a significant improvement in GORD scores but a non-significant worsening of dysphagia scores. Satisfaction scores were also high across all the groups following surgery but lowest in the fundoplication group, possibly as a result of some patients having a degree of dysphagia. This may also help to explain why the response rate was lower in this group. However, the overall response rate in this study is in keeping with what would be expected from similar studies. It is accepted that the lower the response rate, the lower the effective sample size and the greater the risk of bias.15

View Article: PubMed Central - PubMed

ABSTRACT

Patient reported quality of life (QOL) outcomes are important tools for measuring the success of surgical intervention. This is of particular relevance in benign disease when surgery is specifically indicated primarily to treat symptoms and improve QOL. In upper gastrointestinal disease, common conditions such as achalasia, gastro-oeosphageal reflux disease and para-oesophageal hernias can have a significant impact on patient's quality of life. The aim of this study was to compare QOL scores before and after surgery for these conditions, and to assess patient satisfaction.

Patients who underwent laparoscopic paraoesophageal hernia (POH) repair, laparoscopic cardiomyotomy or laparoscopic fundoplication over a 7 year period (2006-2013) by one surgeon were asked to assess their symptoms before and after surgery using the Gastro-oesophageal Reflux Disease-Health Related Quality-Of-Life (GORD-HRQOL) Score and The Royal Adelaide Dysphagia (RAD) Score, and to rate their satisfaction.

All procedures were carried out electively, with no 30- day mortality, and an absence of any major peri-operative morbidity.

Responses were received from 121 patients (68 female and 53 male). This comprised of 34 POH repairs, 39 cardiomyotomies and 48 fundoplications.

Median GORD scores improved significantly for all groups; POH 20.5 to 2, (p<0.0001), Fundoplication 24.5 to 6.5 (p<0.0001), and Cardiomyotomy 21 to 10 (p=0.0008).

Dysphagia scores improved significantly for Cardiomyotomy, 7.5 to 30 (p<0.0001), and POH, 25 to 40.5 (p=0.044), but not with Fundoplication 45 to 35.25 (p =0.17).

64% of patients were ‘satisfied’ or ‘very satisfied’ with their current condition. 77% were 'satisfied’ or ‘very satisfied’ with the procedure itself.

This study has shown that there is a high rate of patient satisfaction following laparoscopic surgery for benign upper GI disease.

No MeSH data available.


Related in: MedlinePlus