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Laparoscopic fundoplication performed in community hospital settings: A protocol for systematic review

Laparoscopic fundoplication (LF) is well-established as the surgical intervention of choice for management of refactory gastro-esophageal reflux disease. Much of its success lies in the reported benefits in symptom control outlined by the postoperative patient. It is unclear whether patient-reported...

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Autores principales: Fadaee, Neesa, Gaszynski, Rafael, Merrett, Neil, Gray, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829280/
https://www.ncbi.nlm.nih.gov/pubmed/36607888
http://dx.doi.org/10.1097/MD.0000000000032502
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author Fadaee, Neesa
Gaszynski, Rafael
Merrett, Neil
Gray, Andrew
author_facet Fadaee, Neesa
Gaszynski, Rafael
Merrett, Neil
Gray, Andrew
author_sort Fadaee, Neesa
collection PubMed
description Laparoscopic fundoplication (LF) is well-established as the surgical intervention of choice for management of refactory gastro-esophageal reflux disease. Much of its success lies in the reported benefits in symptom control outlined by the postoperative patient. It is unclear whether patient-reported outcomes differ according to the institution type providing care. This review aimed to address this knowledge gap by reviewing the available evidence examining patient-reported outcomes of LF in non-metropolitan centers. OBJECTIVES: To investigate patient-reported outcomes of LF performed in regional or community-based hospitals. DATA SOURCES: Four electronic databases, and citations of relevant articles. STUDY ELIGIBILITY CRITERIA: Only studies that separately reported patient-reported outcomes of LF performed in regional or community hospitals were included; papers deemed to be unclear about the type of facility in which LF surgeries were performed, or in which data from LF surgeries performed in regional/community hospitals was combined with data from major metropolitan hospitals, were excluded. STUDY APPRAISAL: Only studies that were graded as fair or good using Quality Assessment Tool for Observational Cohort and Cross-sectional studies were eligible for inclusion in this review. Seven studies were then eligible for inclusion, all of which were observational cohort studies with 6 of the studies reporting on a single intervention arm. RESULTS: Seven observational cohort studies were included in the review, with a combined total of 1071 patients who underwent LF at non-metropolitan centers. Of these, data was collected for 742 patients, yielding an overall response rate of 69.3%. All 7 studies assessed patients’ post-operative outcomes through questionnaires that were based on a modified Likert scale or a similar tool. Overall patient satisfaction was high (86%) and a significant majority of patients stated they would recommend the procedure to others (93.3%). Post-operative prevalence of reflux and dysphagia compared favorably to rates generally reported in the literature (11.9% and 17.6% respectively). Further research is required to ascertain the safety of performing these procedures in non-metropolitan hospitals. CONCLUSION: Current evidence suggests that patient-reported outcomes are favorable for patients undergoing LF in community settings, and are broadly comparable to those undergoing LF in tertiary-level centers.
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spelling pubmed-98292802023-01-24 Laparoscopic fundoplication performed in community hospital settings: A protocol for systematic review Fadaee, Neesa Gaszynski, Rafael Merrett, Neil Gray, Andrew Medicine (Baltimore) 7100 Laparoscopic fundoplication (LF) is well-established as the surgical intervention of choice for management of refactory gastro-esophageal reflux disease. Much of its success lies in the reported benefits in symptom control outlined by the postoperative patient. It is unclear whether patient-reported outcomes differ according to the institution type providing care. This review aimed to address this knowledge gap by reviewing the available evidence examining patient-reported outcomes of LF in non-metropolitan centers. OBJECTIVES: To investigate patient-reported outcomes of LF performed in regional or community-based hospitals. DATA SOURCES: Four electronic databases, and citations of relevant articles. STUDY ELIGIBILITY CRITERIA: Only studies that separately reported patient-reported outcomes of LF performed in regional or community hospitals were included; papers deemed to be unclear about the type of facility in which LF surgeries were performed, or in which data from LF surgeries performed in regional/community hospitals was combined with data from major metropolitan hospitals, were excluded. STUDY APPRAISAL: Only studies that were graded as fair or good using Quality Assessment Tool for Observational Cohort and Cross-sectional studies were eligible for inclusion in this review. Seven studies were then eligible for inclusion, all of which were observational cohort studies with 6 of the studies reporting on a single intervention arm. RESULTS: Seven observational cohort studies were included in the review, with a combined total of 1071 patients who underwent LF at non-metropolitan centers. Of these, data was collected for 742 patients, yielding an overall response rate of 69.3%. All 7 studies assessed patients’ post-operative outcomes through questionnaires that were based on a modified Likert scale or a similar tool. Overall patient satisfaction was high (86%) and a significant majority of patients stated they would recommend the procedure to others (93.3%). Post-operative prevalence of reflux and dysphagia compared favorably to rates generally reported in the literature (11.9% and 17.6% respectively). Further research is required to ascertain the safety of performing these procedures in non-metropolitan hospitals. CONCLUSION: Current evidence suggests that patient-reported outcomes are favorable for patients undergoing LF in community settings, and are broadly comparable to those undergoing LF in tertiary-level centers. Lippincott Williams & Wilkins 2023-01-06 /pmc/articles/PMC9829280/ /pubmed/36607888 http://dx.doi.org/10.1097/MD.0000000000032502 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC) (https://creativecommons.org/licenses/by-nc/4.0/) , where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.
spellingShingle 7100
Fadaee, Neesa
Gaszynski, Rafael
Merrett, Neil
Gray, Andrew
Laparoscopic fundoplication performed in community hospital settings: A protocol for systematic review
title Laparoscopic fundoplication performed in community hospital settings: A protocol for systematic review
title_full Laparoscopic fundoplication performed in community hospital settings: A protocol for systematic review
title_fullStr Laparoscopic fundoplication performed in community hospital settings: A protocol for systematic review
title_full_unstemmed Laparoscopic fundoplication performed in community hospital settings: A protocol for systematic review
title_short Laparoscopic fundoplication performed in community hospital settings: A protocol for systematic review
title_sort laparoscopic fundoplication performed in community hospital settings: a protocol for systematic review
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9829280/
https://www.ncbi.nlm.nih.gov/pubmed/36607888
http://dx.doi.org/10.1097/MD.0000000000032502
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