Study dispels misconceptions of anti-reflux surgery with proof of symptom resolution
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SAN DIEGO — Patients who underwent laparoscopic anti-reflux surgery for gastroesophageal reflux disease experienced long-term improvement in symptoms commonly misperceived to persist, according to study results.
“Our take home-message is to make patients as well as our colleagues — not only the surgeons but also the primary care physicians and gastroenterologists — who are all seeing these patients with GERD symptoms understand that anti-reflux surgery aversion is not the right message for patients,” Mian Hashim Hanif, MD, a fellow at Luminis Health Anne Arundel Medical Center in Maryland, told Healio. “It is very effective, and it has shown to resolve symptoms which are reported online and falsely spreading among the social media platforms. We have proved by our study that there is almost complete resolution of these symptoms.”
Seeking to identify and address common concerns about laparoscopic anti-reflux surgery (LARS), Hanif and colleagues searched various social media platforms and patient-centered forums to find adverse perceptions. Among the most frequently reported were that benefits of anti-reflux surgery are not long-lasting, that patients will have a persistent need for anti-reflux medications postoperatively and will experience postoperative dysphagia or odynophagia, and that fundoplication is not reversible.
Investigators then reviewed a database of approximately 1,350 patients to identify clinical and patient-reported outcomes and quantify rates of preoperative and postoperative symptoms after LARS. Differences in outcomes between preoperative and postoperative periods (30 days-5 years) were assessed with Chi-square tests.
According to study results, patients were less likely to need anti-reflux medication and report symptoms of dysphagia, odynophagia, heartburn, hoarseness, coughing up undigested food or respiratory distress 4 weeks postoperatively compared with preoperatively (all P < .0001). Further, these symptom improvements were steady through the 5-year postoperative period (all P < .001).
According to researchers, 87 patients underwent revision of Nissen fundoplication and 31 underwent conversion from Nissen to Toupet fundoplication. The 30-day readmission rate was 6.8% after revision, and the complication (non-surgical) and reoperation rates were 15% and 3.4%, respectively.
“Using this information, surgeons may counsel patients and colleagues to set accurate expectations and dispel common misconceptions regarding LARS,” Hanif and colleagues concluded.
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Hanif MH, et al. Abstract 757. Presented at: Digestive Disease Week; May 21-24, 2022; San Diego (hybrid meeting).
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