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THE EFFECT OF OBESITY ON THE OUTCOME OF LAPAROSCOPIC ANTIREFLUX SURGERY
Author(s) -
Chisholm J. A.,
Jamieson G. G.,
Lally C. J.,
Devitt P. G.,
Game P. A.,
Watson D. I.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04920_7.x
Subject(s) - medicine , body mass index , contraindication , overweight , obesity , surgery , laparoscopy , reflux , laparoscopic surgery , disease , alternative medicine , pathology
Purpose: Obesity has long been considered to be a predisposing factor for gastroesophageal reflux. It is also thought to predispose patients to a poorer clinical outcome following antireflux surgery. This study examined the effect of body mass index (BMI) on clinical outcomes following laparoscopic antireflux surgery. Methodology: Patients were included if they had undergone a laparoscopic fundoplication, their pre‐surgical BMI was known, and they had been followed for at least 12 months after surgery. The clinical outcome was determined using a structured questionnaire, and this was applied yearly after surgery. Patients were divided into 4 groups according to BMI: normal weight (BMI < 25), overweight (BMI 25–29.9), obese (BMI 30–34.9) and morbidly obese (BMI > or = 35). The most recent clinical outcome data was analysed for each BMI group. Results: 481 patients were studied. 103 (21%) had a normal BMI, 208 (43%) were overweight, 115 (24%) were obese, and 55 (12%) were morbidly obese. Mean follow up was 7.5 years. Conversion to an open operation and requirement for revision surgery were not influenced by preoperative weight. Operating time was longer in obese patients (mean 86 vs. 75 min). Clinical outcomes improved following surgery regardless of BMI. Conclusion: Preoperative BMI does not influence the clinical outcome following laparoscopic antireflux surgery. Obesity is not a contraindication for laparoscopic fundoplication.