Characterization of long-term outcomes after Toupet fundoplication: symptoms, medication use, and health status.

Abstract:

GOALS AND BACKGROUND:Fundoplication is increasingly used for the treatment of gastroesophageal reflux disease (GERD). Few studies have tracked patient outcomes of the Toupet method for more than 1 year. Further clinical, physiologic, and patient-based outcome measures have not been well characterized for this method. The current study conducts a long-term, comprehensive outcome evaluation in patients receiving Toupet fundoplication. STUDY:Fifty-five patients who had previously undergone fundoplication were examined. In a subset of 24 patients, esophagogastroduodenoscopy was used to assess the severity of reflux esophagitis. Manometry and ambulatory pH monitoring also were performed. RESULTS:Patients were studied 2.9 (+/- 0.7) years after surgery. Sixty-seven percent of the sample reported heartburn, 51% reported postoperative bloating, 33% reported regurgitation, and 20% reported dysphagia. Thirty-three percent reported the use of prescription medications for GERD-related symptoms. Health status was diminished relative to population norms. Degree of GERD severity was associated with symptom reports and medication use. CONCLUSIONS:Although fundoplication is thought to be a curative procedure, the current findings suggest that many patients take symptomatic therapies and report symptoms and diminished health status up to 2 years after the procedure. These outcomes are associated with physiologic findings. Thus, these findings suggest that symptom-free status and absence of medication use cannot be assumed for all patients after Toupet fundoplication.

journal_name

J Clin Gastroenterol

authors

Klapow JC,Wilcox CM,Mallinger AP,Marks R,Heudebert GR,Centor RM,Lawrence W,Richter J

doi

10.1097/00004836-200205000-00006

subject

Has Abstract

pub_date

2002-05-01 00:00:00

pages

509-15

issue

5

eissn

0192-0790

issn

1539-2031

journal_volume

34

pub_type

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