BACKGROUND: This study aimed to evaluate early outcomes after antireflux surgery for lung transplant (LTx) recipients in the United States. METHODS: Adult patients undergoing elective antireflux surgery between 2003 and 2008 were identified in the Nationwide Inpatient Sample. A propensity-matched analysis compared early outcomes between prior LTx recipients and well-matched control subjects consisting of non-LTx patients undergoing elective antireflux surgery during the same era. The primary outcome was inpatient mortality, and the secondary outcomes were hospital length of stay (LOS), perioperative complications, and hospital costs. RESULTS: During the study period, 401 LTx recipients underwent elective antireflux surgery. These patients were well matched with 401 control patients in terms of age, sex, individual and overall comorbidity burden, hospital teaching status, hospital location, hospital antireflux volume, and open versus laparoscopic approach. The overall operative mortality rate was 1.4 %, with no difference between the groups. The overall and individual morbidity rates also were similar. The LOS and hospital costs were significantly greater in the LTx group. Multivariable logistic regression analysis confirmed that prior LTx did not confer an increased risk of inpatient mortality after antireflux surgery. CONCLUSIONS: To date, this is the largest study to examine outcomes of antireflux surgery for LTx recipients. Operative mortality and morbidity appear to be comparable with those of the general population, although resource utilization is greater. Based on these data, trials to evaluate the role of antireflux surgery in preserving allograft function after LTx should not be hindered by a perceived notion of prohibitive operative risk in this patient population.
BACKGROUND: This study aimed to evaluate early outcomes after antireflux surgery for lung transplant (LTx) recipients in the United States. METHODS: Adult patients undergoing elective antireflux surgery between 2003 and 2008 were identified in the Nationwide Inpatient Sample. A propensity-matched analysis compared early outcomes between prior LTx recipients and well-matched control subjects consisting of non-LTxpatients undergoing elective antireflux surgery during the same era. The primary outcome was inpatient mortality, and the secondary outcomes were hospital length of stay (LOS), perioperative complications, and hospital costs. RESULTS: During the study period, 401 LTx recipients underwent elective antireflux surgery. These patients were well matched with 401 control patients in terms of age, sex, individual and overall comorbidity burden, hospital teaching status, hospital location, hospital antireflux volume, and open versus laparoscopic approach. The overall operative mortality rate was 1.4 %, with no difference between the groups. The overall and individual morbidity rates also were similar. The LOS and hospital costs were significantly greater in the LTx group. Multivariable logistic regression analysis confirmed that prior LTx did not confer an increased risk of inpatient mortality after antireflux surgery. CONCLUSIONS: To date, this is the largest study to examine outcomes of antireflux surgery for LTx recipients. Operative mortality and morbidity appear to be comparable with those of the general population, although resource utilization is greater. Based on these data, trials to evaluate the role of antireflux surgery in preserving allograft function after LTx should not be hindered by a perceived notion of prohibitive operative risk in this patient population.
Authors: Jason D Christie; Leah B Edwards; Anna Y Kucheryavaya; Christian Benden; Fabienne Dobbels; Richard Kirk; Axel O Rahmel; Josef Stehlik; Marshall I Hertz Journal: J Heart Lung Transplant Date: 2011-10 Impact factor: 10.247
Authors: Sudish C Murthy; Edward R Nowicki; David P Mason; Marie M Budev; Anthony I Nunez; Lucy Thuita; Jeffrey T Chapman; Kenneth R McCurry; Gösta B Pettersson; Eugene H Blackstone Journal: J Thorac Cardiovasc Surg Date: 2011-07 Impact factor: 5.209
Authors: Matthew G Hartwig; Deverick J Anderson; Mark W Onaitis; Shekur Reddy; Laurie D Snyder; Shu S Lin; R Duane Davis Journal: Ann Thorac Surg Date: 2011-08 Impact factor: 4.330
Authors: P R Burton; B Button; W Brown; M Lee; S Roberts; S Hassen; M Bailey; A Smith; G Snell Journal: Dis Esophagus Date: 2009-06-09 Impact factor: 3.429
Authors: Marco Catarci; Paolo Gentileschi; Claudio Papi; Alessandro Carrara; Renato Marrese; Achille Lucio Gaspari; Giovanni Battista Grassi Journal: Ann Surg Date: 2004-03 Impact factor: 12.969
Authors: Denis Hadjiliadis; R Duane Davis; Mark P Steele; Robert H Messier; Christine L Lau; Steve S Eubanks; Scott M Palmer Journal: Clin Transplant Date: 2003-08 Impact factor: 2.863