Quality of life for patients with gastroesophageal reflux disease 2 years after laparoscopic fundoplication -: Evaluation of the results obtained during the initial experience

Background: Health-related quality of life (HRQL) is significantly affected by gastroesophageal reflux disease (GERD), and its evaluation is emerging as a factor important to select treatment options for GERD. Anti-reflux laparoscopic surgery improves HRQL. The aim of this study was to compare the preoperative and medium-term postoperative HRQL in patients submitted to laparoscopic fundoplication during the initial experience to verify its possible influence on HRQL outcomes. Methods: Clinical assessment, endoscopy, and a previously validated HRQL index were performed before and 2 years after surgery in 32 patients who underwent at the beginning of our experience. Results: The esophageal mucosa returned to normal 2 years after laparoscopic fundoplication in 81% of the patients. Heartburn was absent or occasional in 93%, and 65% were free of antisecretory drugs. All postoperative HRQL items were significantly improved (p < 0.0001), with the postoperative curve of HRQL scores superposable to those of healthy Italian subjects (Italian normative sample). Conclusions: The initial phase of learning does not affect the improvement of HRQL observed after laparoscopic antireflux surgery, which is consistent with durable relief of symptoms and endoscopic healing. Evaluation of HRQL should be added to, and probably could replace in most cases, the objective postoperative testing.