Long-term outcome of surgically and medically treated patients with gastroesophageal reflux disease: A matched-pair follow-up study

• Published in: Scandinavian journal of gastroenterology 2005-02, Vol.40 (3), p.264-274
• Main Authors: Olberg, Petter, Johannessen, Rune, Johnsen, Gjermund, Myrvold, Helge E., Bjerkeset, Tormod, Fjösne, Ulf, Petersen, Hermod
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Digestive system. Abdomen; Endoscopy; Enzyme Inhibitors - therapeutic use; Esophagitis; Esophagus; Female; Follow-Up Studies; fundoplication; Fundoplication - methods; Gastroenterology. Liver. Pancreas. Abdomen; Gastroesophageal Reflux - psychology; Gastroesophageal Reflux - therapy; Histamine H2 Antagonists - therapeutic use; Humans; Investigative techniques, diagnostic techniques (general aspects); Laparoscopy; Male; Matched-Pair Analysis; Medical sciences; medical treatment; Middle Aged; Other diseases. Semiology; Patient Satisfaction; Proton Pump Inhibitors; Quality of Life; quality of life assessment; Retrospective Studies; Severity of Illness Index; Surveys and Questionnaires; symptom assessment; Time Factors; Treatment Outcome
• ISSN: 0036-5521; 1502-7708
• DOI: 10.1080/00365520510011588

Objective. A recent randomized study has shown that the long-term effects of continuous medical treatment of gastroesophageal reflux disease (GERD) with a proton-pump inhibitor are comparable to those of open fundoplication. We compared the long-term effects of anti-reflux surgery with those of medical care according to clinical practice. Methods. This is a questionnaire-based 3-10 years follow-up study of 373 patients with GERD operated on in two hospitals with either open or laparoscopic fundoplication, and pair-matched non-operated controls treated medically according to clinical practice. The controls were matched for hospital, age, sex, follow-up time, degree of esophagitis, presence of hiatus hernia and Barrett's esophagus. The questionnaires used for symptoms and health-related quality of life (QoL) were the Gastrointestinal Symptoms Rating Scale and the Psychological General Well-Being Index, respectively. Results. Response rates were about 80%, and 179 pairs of operated patients and controls remained for analysis (102 based on laparoscopic and 77 on open fundoplication). Independently of the surgical technique, the operated patients suffered at the follow-up from significantly (p