M I Booth1, T C Dehn. 1. Department of Surgery, Royal Berkshire Hospital, Reading, UK.
Abstract
OBJECTIVE: To assess whether relief of gastro-oesophageal reflux symptoms in patients with Barrett's oesophagus who undergo laparoscopic anti-reflux surgery is a reliable indicator of acid suppression. DESIGN: Prospective cohort study. SETTING: Surgical department of a large district general hospital. PARTICIPANTS: Twenty-two patients with Barrett's oesophagus and symptomatic gastro-oesophageal reflux who underwent laparoscopic anti-reflux surgery. INTERVENTIONS: Laparoscopic anti-reflux surgery. MAIN OUTCOME MEASURES: Postoperative symptom scores and 24-h pH test results. RESULTS: Twenty-one out of 22 patients had no or minimal residual symptoms postoperatively (Visick I or II). DeMeester symptom scores improved from a median of 5 preoperatively to 0 postoperatively (P < 0.001, Mann-Whitney rank sum test). Eighteen out of 22 patients had postoperative pH studies: three had persisting abnormal acid exposure times postoperatively, but all three were asymptomatic. CONCLUSIONS: In patients with Barrett's oesophagus, relief of reflux symptoms following laparoscopic anti-reflux surgery is unreliable as an indicator of acid reflux suppression.
OBJECTIVE: To assess whether relief of gastro-oesophageal reflux symptoms in patients with Barrett's oesophagus who undergo laparoscopic anti-reflux surgery is a reliable indicator of acid suppression. DESIGN: Prospective cohort study. SETTING: Surgical department of a large district general hospital. PARTICIPANTS: Twenty-two patients with Barrett's oesophagus and symptomatic gastro-oesophageal reflux who underwent laparoscopic anti-reflux surgery. INTERVENTIONS: Laparoscopic anti-reflux surgery. MAIN OUTCOME MEASURES: Postoperative symptom scores and 24-h pH test results. RESULTS: Twenty-one out of 22 patients had no or minimal residual symptoms postoperatively (Visick I or II). DeMeester symptom scores improved from a median of 5 preoperatively to 0 postoperatively (P < 0.001, Mann-Whitney rank sum test). Eighteen out of 22 patients had postoperative pH studies: three had persisting abnormal acid exposure times postoperatively, but all three were asymptomatic. CONCLUSIONS: In patients with Barrett's oesophagus, relief of reflux symptoms following laparoscopic anti-reflux surgery is unreliable as an indicator of acid reflux suppression.