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Antireflux surgery for non‐erosive and erosive reflux disease in community practice
Author(s) -
THIBAULT R.,
CORON E.,
SÉBILLE V.,
SACHERHUVELIN S.,
BRULEY DES VARANNES S.,
GOURNAY J.,
GALMICHE J. P.
Publication year - 2006
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2006.03024.x
Subject(s) - medicine , reflux , disease , quality of life (healthcare) , proton pump inhibitor , multivariate analysis , referral , surgery , nursing , family medicine
SUMMARY Background Antireflux surgery has been mainly evaluated in tertiary referral centres. Data regarding post‐operative outcome in non‐erosive reflux disease are lacking. Aim To assess long‐term outcome after antireflux surgery performed in a community practice setting. Methods We selected consecutively 60 non‐erosive reflux disease patients and 61 erosive oesophagitis patients with symptomatic gastro‐oesophageal reflux disease. After surgery, each subject answered a validated disease‐specific health‐related quality of life questionnaire and another questionnaire focusing on symptoms, late morbidity and drug use. Results After a 43‐month median follow‐up, an excellent outcome was reported by less than two‐thirds of patients. Quality of life scores were lower in the non‐erosive reflux disease group, especially in female patients. Non‐erosive reflux disease patients reported more daily symptoms and more reflux‐related symptoms ( P = 0.04). Proton‐pump inhibitor use was higher in non‐erosive reflux disease patients ( P < 0.005). Multivariate analysis identified four independent predictive factors associated with better outcome, namely male gender, abnormal preoperative acid exposure, a long duration of symptoms and surgical expertise. Conclusions In community practice, the results of antireflux surgery are inferior to those reported by tertiary centres. Outcome seems poorer in non‐erosive reflux disease especially in female patients. Nearly one‐third of the non‐erosive reflux disease patients continue to take proton‐pump inhibitors. These results highlight the need for careful selection of patients before antireflux surgery.