Patient reported quality- of-life following laparoscopic surgery for benign oesophagogastric disease
AuthorsDobson GA, Thompson RJ, Kennedy AK
Departments / InstitutionsBelfast City Hospital, Belfast Health and Social Care Trust
Publication DateSpring 2014
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.
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).
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).
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.