Quality of life before and after antireflux surgery

Introduction: Quality of life data are important issues in estimating the outcome of laparoscopic antireflux surgery.

The aim of this study was to assess the surgical outcomes from the patient's aspect by using a new quality of life instrument (QOLARS) developed and validated by our study group.

Patients and Methods: 33 consecutive patients undergoing laparoscopic “floppy” Nissen (n=25) or Toupet (n=8) fundoplication at our department of surgery between January 2002– July 2003 were evaluated prospectively. The patients included 10 men and 23 women, with mean age of 40 (17–65) years. Quality of life was measured by the QOLARS, a 50-item questionnaire (including Visick score, EORTC QLQ-C30, and the modified GERD-HRQL). Patients completed the questionnaire before surgery, 6 weeks and 1 year after surgery.

Results: Before surgery all patients had a poor quality of life. The general quality of life score (p<0,000) and the heartburn score (p<0,000) improved significantly 6 weeks after and showed further improvement by the end of the 1st postoperative year. The surgical success rate, as defined by Visick score of 1–2, was 85%.

Conclusions: QOLARS is a sensitive tool to assess surgical outcomes after fundoplication. Quality of life response closely follows the clinical outcome of surgical treatment reflecting its side-effects as well. Results of this study, along with other published data showed that laparoscopic antireflux surgery is effective in the improvement of symptom ratings and quality of life.