Health-related and disease-specific quality-of-life assessment after laparoscopic refundoplication

Purpose: In recent years, the efficacy of laparoscopic antireflux surgery h as been well-documented with quality-of-life data. The aim of the present s tudy was to describe the efficacy of laparoscopic redo-surgery using health -related and disease-specific quality-of-life data. Methods:A sample of 30 patients with mean age of 56 years underwent laparoscopic refundoplication. In 18 patients the primary antireflux procedure was performed by the open technique. In 12 cases the primary intervention was performed laparoscopica lly. To evaluate quality-of-life the German SF-36 Health Survey and the Gas trointestinal Quality of Life Index (GIQLI) were used and given to all pati ents before and 3 months and 1 year after redo-surgery. Results: Before sur gery, in two (physical functioning, role physical) out of 8 dimensions of S F-36 the values have not decreased significantly (P < 0.05) compared to hea lthy individuals. Three months after laparoscopic redo-surgery all reduced dimensions improved significantly (P < 0.05). One year after surgery all di mensions are stable and comparable to a healthy population. Prior to redo-s urgery, the mean GIQLI was 86.7 points and improved significantly (P < 0.05 ) to 121.6 and 123.8 points (3 months and 1 year after refundoplication) an d reached an equivalent level of comparable healthy individuals (122.6 poin ts). There are no significant differences between patients with an open and laparoscopic initial antireflux procedure at all times of measurement. Pos toperative data of only 28 patients were included because in two patients c onversion was necessary due to operative problems. Conclusion: Because of t hese results laparoscopic refundoplication can be discussed as an effective method of treatment after failed primary antireflux procedure. Laparoscopi c redo-surgery normalizes objective outcome criteria and also improves qual ity of life.