BACKGROUND: Laparoscopic antireflux surgery is the gold standard for surgical treatment of gastroesophageal reflux disease (GERD), and a well-defined learning curve for the procedure has been described. This study aimed to assess whether the surgeon's experience has an effect on 1-year symptom scores and patient satisfaction. METHODS: All the patients who underwent antireflux surgery were entered into a prospectively maintained database including 1-year postoperative symptom scores. The database was queried in June 2008 to identify patients who had been followed up for 1 year. To decrease variability, the patients with a large hiatal hernia (>5 cm), paraesophageal hernia, treatment with partial fundoplication, a required Collis gastroplasty, or treatment with a transthoracic procedure were excluded from the study. RESULTS: From September 2003 to March 2007, 215 consecutive patients underwent primary antireflux surgery. Of these 215 patients, 158 (93 women with a mean age of 50.9 ± 13.6 years; range, 18-87 years) met the inclusion criteria and were divided into three groups: early group (9/2003-10/2004), mid group (10/2004-12/2005), and late group (12/2005-3/2007). Experience significantly decreased the mean operative time (P < 0.05) and the hospital stay (P < 0.05). Additionally, the number of patients who required reoperative intervention also decreased with experience. There was no difference in the patient-reported symptom scores at 1 year for heartburn (mean, 0.3 ± 0.7), regurgitation (mean, 0.1 ± 0.4), or dysphagia (mean, 0.3 ± 0.6) (P > 0.05 for each). However, chest pain (mean, 0.2 ± 0.4) was significantly improved with experience (P < 0.05). The overall patient-reported mean satisfaction was 9.0 ± 1.9 (P > 0.05, scale, 1-10), and 14.5% (19/131) of the patients reported use of acid suppression medications. CONCLUSIONS: A high degree of 1-year symptom resolution and satisfaction can be achieved even early in a surgeon's experience provided there is adequate training and maintenance of strict adherence to technique.
BACKGROUND: Laparoscopic antireflux surgery is the gold standard for surgical treatment of gastroesophageal reflux disease (GERD), and a well-defined learning curve for the procedure has been described. This study aimed to assess whether the surgeon's experience has an effect on 1-year symptom scores and patient satisfaction. METHODS: All the patients who underwent antireflux surgery were entered into a prospectively maintained database including 1-year postoperative symptom scores. The database was queried in June 2008 to identify patients who had been followed up for 1 year. To decrease variability, the patients with a large hiatal hernia (>5 cm), paraesophageal hernia, treatment with partial fundoplication, a required Collis gastroplasty, or treatment with a transthoracic procedure were excluded from the study. RESULTS: From September 2003 to March 2007, 215 consecutive patients underwent primary antireflux surgery. Of these 215 patients, 158 (93 women with a mean age of 50.9 ± 13.6 years; range, 18-87 years) met the inclusion criteria and were divided into three groups: early group (9/2003-10/2004), mid group (10/2004-12/2005), and late group (12/2005-3/2007). Experience significantly decreased the mean operative time (P < 0.05) and the hospital stay (P < 0.05). Additionally, the number of patients who required reoperative intervention also decreased with experience. There was no difference in the patient-reported symptom scores at 1 year for heartburn (mean, 0.3 ± 0.7), regurgitation (mean, 0.1 ± 0.4), or dysphagia (mean, 0.3 ± 0.6) (P > 0.05 for each). However, chest pain (mean, 0.2 ± 0.4) was significantly improved with experience (P < 0.05). The overall patient-reported mean satisfaction was 9.0 ± 1.9 (P > 0.05, scale, 1-10), and 14.5% (19/131) of the patients reported use of acid suppression medications. CONCLUSIONS: A high degree of 1-year symptom resolution and satisfaction can be achieved even early in a surgeon's experience provided there is adequate training and maintenance of strict adherence to technique.
Authors: T K Rantanen; T V Halme; M E Luostarinen; L M Karhumäki; E O Könönen; J O Isolauri Journal: Am J Gastroenterol Date: 1999-07 Impact factor: 10.864
Authors: R J Landreneau; R J Wiechmann; S R Hazelrigg; T S Santucci; T M Boley; M J Magee; K S Naunheim Journal: Ann Thorac Surg Date: 1998-12 Impact factor: 4.330
Authors: M Luostarinen; J Isolauri; J Laitinen; M Koskinen; O Keyriläinen; H Markkula; E Lehtinen; A Uusitalo Journal: Gut Date: 1993-08 Impact factor: 23.059
Authors: Giuseppe Amato; Paolo Limongelli; Annalisa Pascariello; Gianluca Rossetti; Gianmattia Del Genio; Alberto Del Genio; Paola Iovino Journal: Am J Surg Date: 2008-05-07 Impact factor: 2.565
Authors: Dominic R Parker; Tim Bright; Tanya Irvine; Sarah K Thompson; David I Watson Journal: J Gastrointest Surg Date: 2019-04-22 Impact factor: 3.452