Efficacy of, and quality of life after antireflux surgery.

A complete evaluation of reflux operations depends on measurements of preoperative and postoperative clinical symptoms such as dysphagia and heartburn, assessment of quality of life and objective measurements of 24-hour oesophageal pH monitoring and manometry. Quality of life can be measured with questionnaires such as the Gastrointestinal Symptom Rating Scale (GSRS), the Psychological General Wellbeing Index (PGWB) and the Reflux-related Visual Analogue Scale (RVAS). Failure of treatment is indicated by persistent symptoms such as heartburn, need for antisecretory medication, and new symptoms such as severe dysphagia. The advantages of laparoscopic operations are mainly a quick recovery and a good cosmetic results. Good short-term cure of symptoms is reported in 90%-97% of patients who have laparoscopic fundoplication. The long-term clinical outcome is equal to or better than that of open operations. Several clinical studies have shown that laparoscopic fundoplication is effective in improving symptom ratings and the quality of life.