QUALITY-OF-LIFE ASSESSMENT AFTER LAPAROSCOPIC AND OPEN FUNDOPLICATIONS - RESULTS OF A PROSPECTIVE, CLINICAL-STUDY

Background: In the evaluation of different treatment alternatives, ass essment of the patients' own perceived situation can give important cl inical information in addition to the conventional efficacy variables used. Methods: Fifty patients with chronic gastroesophageal reflux dis ease (GERD) were operated on with either an open fundoplication (n = 2 5; 17 men; mean age, 51.5 years) or with a fundoplication through the laparoscope (n = 25; 16 men; mean age, 49.8 years). In each case adequ ate control of the GERD was achieved with the operation, also when obj ectively assessed. Twelve months after surgery the quality of life was studied by using a battery of self-administered questionnaires (the P sychological General Well-being (PGWB) index and the Gastrointestinal Symptom Rating Scale (GSRS)) and a visual analogue scale, depicting sp ecific reflux-related symptoms (RVAS). Result: After antireflux surger y the overall PGWB scores were normalized with no obvious difference b etween the two procedures. In the GSRS scale, however, differences wer e shown between the two procedures, with more dyspeptic and indigestio n symptoms in patients having a laparoscopic total fundic wrap. Conclu sion: These data emphasize the clinical efficacy of antireflux surgery , with normalization of the quality of life in terms of well-being aft er these procedures. It should be noted that these instruments are sen sitive enough to pick up significant differences between different ant ireflux procedures and should therefore be frequently used in the atte mpt to refine and optimize long-term therapeutic alternatives in reflu x disease.