Impact of gender and age on the long-term outcome of laparoscopic fundoplication.

Abstract:

BACKGROUND:It has been suggested that gender and age could be factors that influence the likelihood of success following antireflux surgery, and our anecdotal impression has been that the outcome following Nissen fundoplication in older women is often disappointing. If correct, characterization of the extent of any differences in outcome might help patient selection and, hence, surgical outcomes. Therefore, in this study we investigated the impact of gender and age on longer-term clinical outcomes following laparoscopic fundoplication. METHODS:Perioperative and follow-up data from patients undergoing laparoscopic fundoplication in our departments have been collected prospectively and stored in a database. From the database, patients who had undergone either an anterior 180 degrees partial or 360 degrees total laparoscopic fundoplication for gastroesophageal reflux and completed 5 years clinical follow-up were identified. Patients were classified according to gender and age, and outcome data were analyzed to determine differences. Analog scales of 0-10 were used to determine symptoms of heartburn and dysphagia and overall satisfaction. RESULTS:Seven hundred three patients were studied (58% males). Females were less satisfied with the outcome (score = 7.8 +/- 2.8 vs. 8.4 +/- 2.5, P = 0.0036), and had higher scores for heartburn (2.0 +/- 2.7 vs. 1.2 +/- 2.2; P = 0.0001) and dysphagia for solid food (2.7 +/- 2.9 vs. 2.0 +/- 2.5, P = 0.0049) compared to males. Revisional procedures were undertaken more frequently in females (15.5% vs. 8.4%, P = 0.0038). Age had no impact on any clinical outcome. CONCLUSIONS:While the outcome for laparoscopic fundoplication is not influenced by age, the outcome for women is poorer than in males.

journal_name

World J Surg

journal_title

World journal of surgery

authors

Beck PE,Watson DI,Devitt PG,Game PA,Jamieson GG

doi

10.1007/s00268-009-0216-y

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

2620-6

issue

12

eissn

0364-2313

issn

1432-2323

journal_volume

33

pub_type

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