Obesity and its effect on outcome of laparoscopic Nissen fundoplication

Obesity has long been suspected as predisposing to gastroesophageal reflux disease, and it has also been claimed that it is an important cause of poor outcome following laparoscopic anti-reflux surgery. This study was perform ed to determine the validity of this proposition. The outcome of 194 patien ts from an overall experience of 971 laparoscopic anti-reflux procedures wa s determined in this study. Patients were included if they had undergone a laparoscopic Nissen fundoplication, had completed a minimum 12 months follo w-up using a structured questionnaire, and had data available for the calcu lation of their preoperative body mass index (BMI). Patients were divided i nto three groups based on BMI: normal weight (BMI < 25), overweight (BMI 25 -29.9), and obese (BMI > 30). The association between BMI and outcome data from their most recent follow-up was analyzed. There was no correlation bet ween increasing BMI and a poorer overall outcome. There was a slight trend toward less satisfaction with the surgical outcome in patients of normal we ight. Preoperative obesity is not associated with a poorer outcome followin g laparoscopic Nissen fundoplication.