Less invasive surgery effective in treatment of reflux disease

Laparoscopic (minimally invasive) surgery to treat severe reflux disease was effective in relieving symptoms and was associated with high rates of patient satisfaction five years after the procedure, according to a study in the October issue of Archives of Surgery.

Laparoscopic anti-reflux surgery has been gaining in popularity for the treatment of severe symptomatic gastroesophageal reflux disease (GERD), according to background information in the article. Few previous studies have reported five-year follow-up for a large group of patients who have undergone laparoscopic surgery to treat severe reflux disease.

Patrick Pessaux, M.D., of the University Hospital, Angers, France, and colleagues evaluated patients who had undergone one of three types of laparoscopic anti-reflux surgery in one of 31 hospital centers between January 1992 and December 1998. Outcome data covering five or more years was available for 1,340 patients, 815 men and 525 women (average age 49.3 years). The average follow-up was 7.1 years. Patients were evaluated post-operatively using a standardized questionnaire including questions on gastrointestinal symptoms and satisfaction with surgery.

"In this study, the intraoperative and postoperative complication rates were 2.1 percent and 2.6 percent, respectively, with a subsequent operation rate of 4.4 percent at five years," the researchers report. "Of interest, overall patient satisfaction following surgery was high, with 93.1 percent of patients satisfied with their long-term outcome and 94.1 percent willing to have the surgery again. Although nearly 10 percent of patients resumed taking antisecretory medication, in most no evidence of reflux recurrence could be found."

"In conclusion, the results of this study do not differ significantly from the data reported in the literature, suggesting that laparoscopic antireflux surgery is an effective long-term procedure, is well tolerated, and can be properly used in the treatment of GERD," the authors write.