The use of medication after laparoscopic antireflux surgery.

  • Ciovica R
  • Riedl O
  • Neumayer C
 et al. 
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Abstract

Background: Laparoscopic antireflux surgery (LARS) significantly improves symptoms of gastro-esophageal reflux disease (GERD) and quality of life. Nevertheless, 14-62% of patients report using antisecretory medication after surgery, although only a tiny percentage has proven recurrence of GERD. We sought to determine symptoms of GERD, quality of life, and use of medication before and after LARS, and to compare our findings with those from previous studies.Methods: Five hundred fifty-three patients with GERD who underwent LARS were evaluated before and at 1 year after surgery. After surgery, multidisciplinary follow-up care was provided for all patients by surgeons, psychologists, dieticians, and speech therapists.Results: Symptoms of GERD and quality of life improved significantly and only 4.2% of patients still required medication after surgery [proton pump inhibitors (PPI) (98.4 vs. 2.2%; p < 0.01), prokinetics (9.6 vs. 1.1%; p < 0.01), and psychiatric medication (8 vs. 1.6%; p < 0.01)].Conclusion: LARS significantly reduced medication use at 1-year follow-up. However, these effects might be attributed, in part, to the multidisciplinary follow-up care. Further studies are therefore required to investigate which patients may benefit from multidisciplinary follow-up care and whether its selective application may reduce the need for medication after LARS.

Author-supplied keywords

  • Adolescence
  • Adult
  • Aged
  • Antianxiety Agents -- Therapeutic Use
  • Antidepressive Agents -- Therapeutic Use
  • Combined Modality Therapy
  • Drug Utilization -- Statistics and Numerical Data
  • Female
  • Gastroesophageal Reflux -- Drug Therapy
  • Gastroesophageal Reflux -- Surgery
  • Gastrointestinal Agents -- Therapeutic Use
  • Human
  • Laparoscopy
  • Male
  • Middle Age
  • Multidisciplinary Care Team
  • Postoperative Period
  • Prospective Studies
  • Proton Pump Inhibitors -- Therapeutic Use
  • Quality of Life
  • Recurrence
  • Surgery, Digestive System
  • Young Adult

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Authors

  • R Ciovica

  • O Riedl

  • C Neumayer

  • W Lechner

  • Schwab GP

  • M Gadenstätter

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