RESUMO
BACKGROUND: Today, antireflux surgery has an established position in the management of gastroesophageal reflux disease. Some case series have shown good short-term results, but there is still little information regarding long-term results. Studies have recently focused on evaluating residual symptomatology and its impact on quality of life. OBJECTIVES: To determine the postoperative quality of life and degree of satisfaction in patients that underwent laparoscopic Nissen fundoplication. PATIENTS AND METHODS: A total of 100 patients (59 women and 41 men) were studied after having undergone laparoscopic Nissen fundoplication. The variables analyzed were level of satisfaction, gastrointestinal quality of life index (GIQLI), residual symptoms, and the Visick scale. RESULTS: No variation was found in relation to sex; 49 men and 51 women participated in the study. The mean age was 49 years. The degree of satisfaction encountered was: satisfactory in 81 patients, moderate in 3, and bad in 2 patients. More than 90% of the patients would undergo the surgery again or recommend it. The Carlsson score showed improvement at the end of the study (p<0.05). In relation to the GIQLI, a median of 100.61 points±21.624 was obtained. Abdominal bloating, regurgitation, and early satiety were the most frequent residual symptoms. The effect on lifestyle measured by the Visick scale was excellent. CONCLUSIONS: The level of satisfaction and quality of life obtained were comparable with reported standards; and the residual symptoms after antireflux surgery were easily controlled.
Assuntos
Fundoplicatura/psicologia , Refluxo Gastroesofágico/cirurgia , Laparoscopia/psicologia , Satisfação do Paciente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Deglutição/epidemiologia , Feminino , Refluxo Gastroesofágico/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: The purpose of this study was to establish baseline data for a procedure that has yet to be defined within a Caribbean population. Using a specifically designed postoperative questionnaire, symptomatology and quality of life were assessed before and after laparoscopic Nissen fundoplication. METHODS: Twenty-three consecutive patients of the same surgeon were identified. The questionnaires measured the symptoms and social and emotional functioning, assigning each a score for comparative purposes. The cumulative score was considered the ultimate index of overall quality of life. Wilcoxon matched pairs test was used to analyse the data. RESULTS: The mean age of the patients was 47.5 years. There were 21females and 2 males. Heartburn (78.3%) and regurgitation (60.8%) were the main symptoms. Postoperatively, these decreased to 17.3% and 4.3% respectively, with significant declines in other complaints such as dysphagia and nausea. The social and emotional functioning score had an average of 13.2 preoperatively; this increased to 18.3, postoperatively, out of a possible maximum of 20. None of the procedures had to be converted to open laparotomy and mean operating time was 108 minutes. Mean follow-up time was 9.7 months. CONCLUSION: Laparoscopic Nissen fundoplication does provide significant improvement in overall quality of life among patients with gastrointestinal symptoms and can be performed effectively within a Caribbean setting.
Assuntos
Fundoplicatura/métodos , Refluxo Gastroesofágico/cirurgia , Qualidade de Vida , Adolescente , Adulto , Idoso , Criança , Feminino , Fundoplicatura/psicologia , Refluxo Gastroesofágico/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estatísticas não Paramétricas , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: The purpose of this study was to establish baseline data for a procedure that has yet to be defined within a Caribbean population. Using a specifically designed postoperative questionnaire, symptomatology and quality of life were assessed before and after laparoscopic Nissen fundoplication. METHODS: Twenty-three consecutive patients of the same surgeon were identified. The questionnaires measured the symptoms and social and emotional functioning, assigning each a score for comparative purposes. The cumulative score was considered the ultimate index of overall quality of life. Wilcoxon matched pairs test was used to analyse the data. RESULTS: The mean age of the patients was 47.5 years. There were 21 females and 2 males. Heartburn (78.3%) and regurgitation (60.8%) were the main symptoms. Postoperatively, these decreased to 17.3% and 4.3% respectively, with significant declines in other complaints such as dysphagia and nausea. The social and emotional functioning score had an average of 13.2 preoperatively; this increased to 18.3, postoperatively, out of a possible maximum of 20. None of the procedures had to be converted to open laparotomy and mean operating time was 108 minutes. Mean follow-up time was 9.7 months. CONCLUSION: Laparoscopic Nissen fundoplication does provide significant improvement in overall quality of life among patients with gastrointestinal symptoms and can be performed effectively within a Caribbean setting.
OBJETIVO: El propósito de este estudio fue establecer los datos básicos para un procedimiento que tiene que ser definido todavía en el contexto de una población caribeña. Usando una encuesta postoperatoria específicamente diseñada, la sintomatología y la calidad de vida fueron evaluadas antes y después de la fundoplicación laparoscópica de Nissen. MÉTODOS: Se identificaron veintitrés pacientes consecutivos del mismo cirujano. Las encuestas midieron los síntomas así como el funcionamiento social y emocional, asignando a cada uno una puntuación a fin de establecer comparaciones. La puntuación cumulativa fue considerada el índice final de la calidad general de vida. La prueba de pares equiparados de Wilcoxon se usó para analizar los datos. RESULTADOS: La edad promedio de los pacientes (21 hembras y 2 varones) fue 47.5 años. La acidez estomacal (78.3%) y la regurgitación (60.8%) fueron los síntomas principales. Postoperatoriamente, éstos disminuyeron a 17.3% y 4.3% respectivamente, con disminuciones significativas en el caso de otras dolencias, tales como la disfagia y la náusea. La puntuación del funcionamiento social y emocional tuvo un promedio de 13.2 preoperatoriamente. Este aumentó a 18.3 postoperatoriamente, de un máximo posible de 20. Ninguno de los procedimientos tuvo que ser convertido a laparotomía abierta y el tiempo promedio de operación fue de 108 minutos. El tiempo promedio de seguimiento fue de 9.7 meses. CONCLUSIÓN: La fundoplicación laparoscópica de Nissen proporciona un mejoramiento significativo de la calidad general de vida entre los pacientes con síntomas GI y puede realizarse de modo efectivo en un contexto caribeño.