Patient reported quality- of-life following laparoscopic surgery for benign oesophagogastric disease

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Aims

Patient reported quality-of-life (QoL) is an important factor in assessing surgical outcomes for benign disease. The aim of this study was to compare disease-specific QoL scores before and after laparoscopic surgery for benign oesophagogastric disease.

Methods

181 patients who underwent laparoscopic paraoesophageal hernia (POH) repair, cardiomyotomy for achalasia or fundoplication for gasto-oesophageal reflux disease (GORD) between 2006 and 2013 by a single surgeon were asked to assess their symptoms using the GORD Health Related QoL Score and The Royal Adelaide Dysphagia Score (0=complete dysphagia, 45=normal).

Results

Responses were received from 121 patients comprising 34 POH repairs, 39 cardiomyotomies and 48 fundoplications. Median GORD scores improved significantly for all groups after surgery; POH 20.5 to 2 (p<0.0001), fundoplication 24.5 to 6.5 (p<0.0001) and cardiomyotomy 21 to 10 (p=0.0008). Dysphagia scores also improved significantly in the cardiomyotomy (7.5 to 30; p<0.0001) and POH groups (25 to 40.5; p=0.044). There was a non-significant worsening of dysphagia scores after fundoplication (45 to 35.25; p =0.17).

Conclusion

This study has shown that symptoms of GORD and dysphagia can be significantly improved following laparoscopic POH repair and cardiomyotomy. GORD scores are also significantly better after fundoplication but with a nonsignificant worsening in dysphagia scores.