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Gastrointestinal symptoms and patient satisfaction more than 1 year after laparoscopic Nissen fundoplication

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Abstract

Background

Symptoms from poorly controlled gastroesophageal reflux disease (GERD) such as heartburn and regurgitation often resolve after laparoscopic Nissen fundoplication. Unfortunately, new gastrointestinal symptoms such as bloating may occur for some patients. Accurate data regarding the gastrointestinal symptoms experienced by patients who have had a laparoscopic fundoplication may help patients to make more informed decisions about pursuing surgery for their reflux disease.

Methods

Patients more than 12 months after a laparoscopic Nissen fundoplication were mailed symptom surveys. Before surgery, all the patients had medically refractory esophageal symptoms (heartburn, regurgitation, or both). Surveys included the Gastrointestinal Quality of Life Index (GIQLI) and questions regarding satisfaction, reintervention, and medication use. Responses for individual GIQLI items were evaluated to determine the gastrointestinal symptoms experienced by fundoplication patients and the relationship of these symptoms to patient satisfaction.

Results

Of the 76 patients eligible for inclusion in the survey, 48 returned complete surveys (63%). The mean time since surgery was 28 ± 9 months. No patient experienced frequent regurgitation, and few (10%) reported frequent heartburn at follow-up assessment. No patient required redo fundoplication during the follow-up period. Acid reduction medications were resumed by 25% of the patients, but not all of these patients resumed medications for recurrent GERD symptoms (15% total). After surgery, frequent bloating (21%) and excessive flatus (46%) were often noted. Satisfaction with the results of surgery was high, including 83% of the patients.

Conclusions

Few patients report frequent regurgitation or heartburn after laparoscopic Nissen fundoplication. Although some patients resume acid reduction medications, many do so for reasons other than recurrent GERD symptoms. Most fundoplication patients are quite satisfied with the symptomatic results of surgery, although frequent functional gastrointestinal symptoms are common.

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Disclosures

Daniel McKenna, Gretchen Beverstein, and Jon Gould have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Indianapolis, IN, 46202, USA

    Daniel McKenna

  2. Department of Surgery, University of Wisconsin School of Medicine and Public Health, H4/726 Clinical Science Center, 600 Highland Avenue, Madison, WI, 53792, USA

    Gretchen Beverstein & Jon Gould

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  1. Daniel McKenna
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  2. Gretchen Beverstein
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  3. Jon Gould
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Correspondence to Jon Gould.

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McKenna, D., Beverstein, G. & Gould, J. Gastrointestinal symptoms and patient satisfaction more than 1 year after laparoscopic Nissen fundoplication. Surg Endosc 25, 1797–1801 (2011). https://doi.org/10.1007/s00464-010-1466-3

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  • DOI: https://doi.org/10.1007/s00464-010-1466-3

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