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Long-Term Health-Related Quality of Life (HRQoL) After Redo-Fundoplication
BACKGROUND: We aim to shed light on long-term subjective outcomes after re-operations for failed fundoplication. METHODS: 1809 patients were operated on for hiatal hernia and/or gastroesophageal reflux disease (GERD) at the Helsinki University Hospital between 2000 and 2017. 111 (6%) of these had un...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026436/ https://www.ncbi.nlm.nih.gov/pubmed/33502565 http://dx.doi.org/10.1007/s00268-021-05954-3 |
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author | Kivelä, Antti J. Kauppi, Juha Räsänen, Jari But, Anna Sintonen, Harri Vironen, Jaana Kruuna, Olli Scheinin, Tom |
author_facet | Kivelä, Antti J. Kauppi, Juha Räsänen, Jari But, Anna Sintonen, Harri Vironen, Jaana Kruuna, Olli Scheinin, Tom |
author_sort | Kivelä, Antti J. |
collection | PubMed |
description | BACKGROUND: We aim to shed light on long-term subjective outcomes after re-operations for failed fundoplication. METHODS: 1809 patients were operated on for hiatal hernia and/or gastroesophageal reflux disease (GERD) at the Helsinki University Hospital between 2000 and 2017. 111 (6%) of these had undergone a re-operation for a failed antireflux operation. Overall, HRQoL was assessed in 89 patients at the latest follow-up using the generic 15D© instrument. The results were compared to a sample of the general population, weighted to reflect the age and gender distribution of patients. Disease-specific HRQoL was assessed using the GERD-HRQoL questionnaire. We studied variation in the overall HRQoL with respect to disease-specific HRQoL and known patients' parameters using univariate and multivariable linear regression models. RESULTS: The median postoperative follow-up period was 9.3 years. All patients were operated on laparoscopically (6% conversion rate), and 87% were satisfied with the re-operation. Postoperative complications were minimal (5%). Twelve patients (11%) underwent a second re-operation. The median GERD-HRQoL score was nine. In multivariable analysis, four variables were independently associated with the 15D score, suggesting a decrease in the 15D score with increasing GERD-HRQoL score, increasing Charlson Comorbidity Index (CCI) and the presence of chronic pain syndrome (CPS) and depression. CONCLUSION: Re-do LF is a safe procedure in experienced hands and may offer acceptable long-term alleviation in patients with recurring symptoms after antireflux surgery. Decreased HRQoL in the long run is related to recurring GERD and co-morbidities. |
format | Online Article Text |
id | pubmed-8026436 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-80264362021-04-26 Long-Term Health-Related Quality of Life (HRQoL) After Redo-Fundoplication Kivelä, Antti J. Kauppi, Juha Räsänen, Jari But, Anna Sintonen, Harri Vironen, Jaana Kruuna, Olli Scheinin, Tom World J Surg Original Scientific Report BACKGROUND: We aim to shed light on long-term subjective outcomes after re-operations for failed fundoplication. METHODS: 1809 patients were operated on for hiatal hernia and/or gastroesophageal reflux disease (GERD) at the Helsinki University Hospital between 2000 and 2017. 111 (6%) of these had undergone a re-operation for a failed antireflux operation. Overall, HRQoL was assessed in 89 patients at the latest follow-up using the generic 15D© instrument. The results were compared to a sample of the general population, weighted to reflect the age and gender distribution of patients. Disease-specific HRQoL was assessed using the GERD-HRQoL questionnaire. We studied variation in the overall HRQoL with respect to disease-specific HRQoL and known patients' parameters using univariate and multivariable linear regression models. RESULTS: The median postoperative follow-up period was 9.3 years. All patients were operated on laparoscopically (6% conversion rate), and 87% were satisfied with the re-operation. Postoperative complications were minimal (5%). Twelve patients (11%) underwent a second re-operation. The median GERD-HRQoL score was nine. In multivariable analysis, four variables were independently associated with the 15D score, suggesting a decrease in the 15D score with increasing GERD-HRQoL score, increasing Charlson Comorbidity Index (CCI) and the presence of chronic pain syndrome (CPS) and depression. CONCLUSION: Re-do LF is a safe procedure in experienced hands and may offer acceptable long-term alleviation in patients with recurring symptoms after antireflux surgery. Decreased HRQoL in the long run is related to recurring GERD and co-morbidities. Springer International Publishing 2021-01-27 2021 /pmc/articles/PMC8026436/ /pubmed/33502565 http://dx.doi.org/10.1007/s00268-021-05954-3 Text en © The Author(s) 2021, corrected publication 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Scientific Report Kivelä, Antti J. Kauppi, Juha Räsänen, Jari But, Anna Sintonen, Harri Vironen, Jaana Kruuna, Olli Scheinin, Tom Long-Term Health-Related Quality of Life (HRQoL) After Redo-Fundoplication |
title | Long-Term Health-Related Quality of Life (HRQoL) After Redo-Fundoplication |
title_full | Long-Term Health-Related Quality of Life (HRQoL) After Redo-Fundoplication |
title_fullStr | Long-Term Health-Related Quality of Life (HRQoL) After Redo-Fundoplication |
title_full_unstemmed | Long-Term Health-Related Quality of Life (HRQoL) After Redo-Fundoplication |
title_short | Long-Term Health-Related Quality of Life (HRQoL) After Redo-Fundoplication |
title_sort | long-term health-related quality of life (hrqol) after redo-fundoplication |
topic | Original Scientific Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026436/ https://www.ncbi.nlm.nih.gov/pubmed/33502565 http://dx.doi.org/10.1007/s00268-021-05954-3 |
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