Multicenter Prospective Study of Laparoscopic Nissen Fundoplication for Gastroesophageal Reflux Disease in Korea
박성수, 박중민, 김진조, 이인섭, 한상욱, 서경원, 권진원,
소속 상세정보
박성수 ( Park Sung-Soo )
Korea University College of Medicine Department of Surgery
박중민 ( Park Joong-Min )
Chung-Ang University College of Medicine Department of Surgery
김진조 ( Kim Jin-Jo )
Catholic University College of Medicine Department of Surgery
이인섭 ( Lee In-Seob )
University of Ulsan College of Medicine Asan Medical Center Department of Surgery
한상욱 ( Han Sang-Uk )
Ajou University School of Medicine Department of Surgery
서경원 ( Seo Kyung-Won )
Kosin University College of Medicine Department of Surgery
권진원 ( Kwon Jin-Won )
Kyungpook National University College of Pharmacy
Abstract
Backgrounds/Aims: This multicenter study aims to evaluate the effect and feasibility of anti-reflux surgery compared with medical treatment for gastroesophageal reflux disease (GERD).
Methods: Patients with GERD who were undergoing medical treatment with proton pump inhibitors for more than 8 weeks and those who were scheduled to undergo anti-reflux surgery were enrolled. Efficacy of pre-operative medical treatment was evaluated retrospectively and effect of anti-reflux surgery was prospectively evaluated at 1 week and 3 months after surgery. Quality of life (QOL) was also investigated before and after surgery.
Results: Between February and October 2018, 51 patients underwent laparoscopic Nissen fundoplication for treating GERD at 5 hospitals in Korea. Thirty-four patients (66.7%) showed poor proton pump inhibitor response. At 3 months after surgery, heartburn was completely resolved in 87.9% patients and partially improved in 9.1%. Acid regurgitation was completely resolved in 82.9% and partially improved in 11.4%. Atypical extraesophageal symptoms were completely controlled in 45.5% and partially controlled in 36.4%. GERD-related QOL scores at 1 week after surgery significantly improved compared with pre-operative scores. There was no difference in GERD-related QOL scores between 1 week and 3 months after surgery. General QOL measured with European QOL-5 dimensions and health-related QOL instrument with 8 items significantly improved after anti-reflux surgery. Satisfaction with treatment was significantly higher after surgery than before surgery (72.5% vs 11.8%, P < 0.001).
Conclusion: Anti-reflux surgery improved GERD symptoms and QOL in patients. Anti-reflux surgery is an effective treatment option compared with medical treatment for GERD patients selected for surgical treatment.
키워드
Fundoplication; Gastroesophageal reflux; Laparoscopy; Quality of life
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