Long-term satisfaction and medication dependence after antireflux surgery.

Abstract

Antireflux surgery remains an important treatment for gastroesophageal reflux disease (GERD) refractory to medical management. However, there is a paucity of data on long-term surgical outcomes. The objectives of this study were to determine long-term patient satisfaction and medication dependence after antireflux surgery. We identified all patients having antireflux surgery for GERD at our institution between 2000 and 2010. Medical records were reviewed and long-term outcomes were assessed using telephone surveys. Cox proportional hazards models were used to identify significant predictors of patient satisfaction and medication use 5 years and 10 years after surgery. We surveyed 195 patients receiving antireflux surgery with a median follow-up of 6.3 years; 191 of 195 operations (98%) were performed laparoscopically. Five years after surgery, 82% of patients were satisfied with their operation and 83% of patients were not taking any antireflux medication. At 10 years postoperatively, these rates drop to 59% and 38%, respectively. Of patients taking medication who received formal evaluation of their symptoms, only 38.5% (15 of 39) had evidence of reflux. Age, sex, year of operation, surgeon specialty, body mass index, and presenting symptom were not associated with long-term satisfaction or medication use. Antireflux surgery dramatically improves symptoms and provides excellent 5-year patient satisfaction and freedom from medication use. However, both of these outcomes decrease with follow-up out to 10 years.