Use of acid suppressive medications after laparoscopic antireflux surgery: prevalence and clinical indications - PubMed (original) (raw)

Use of acid suppressive medications after laparoscopic antireflux surgery: prevalence and clinical indications

Hugo Bonatti et al. Dig Dis Sci. 2007 Jan.

Abstract

Laparoscopic antireflux surgery (LARS) provides effective control of gastroesophageal reflux (GER) in more than 90% of patients. Despite this high success rate, some patients continue to consume acid suppressive medications after surgical intervention. In this study we evaluate the prevalence, clinical indications, and cause of use of acid reducing drugs in patients after LARS. Consecutive patients undergoing LARS for GERD were surveyed 2-3 years after surgery regarding use of acid suppressive medications, surgical outcome, and GERD specific symptoms. During the study period, 119 patients underwent LARS at our center. Ninety-eight (82%) were available for interview. Two patients died of unrelated causes and two declined to be interviewed. The remaining 94 individuals are the subject of this report. Ninety-four percent were satisfied with the outcome of surgery. Despite this high satisfaction rate, 37 of 94 (39%) were on antireflux medication (ARM; 62% proton pump inhibitors, 22% H2-receptor antagonists, and 16% others), with 70% using continuous medication. Of these patients, 54% took ARM after surgery for GERD-related symptoms, 95% of these patients responded to medical therapy, and yet again, 85% remained satisfied with the surgical outcome. Forty-six percent of patients on ARM after surgery had no GERD symptoms and took ARM for nonappropriate indications such as bloating. Only 47% of these responded to ARM; 82% of this group was satisfied with the surgical outcome. In conclusion, the use of ARM after LARS is a common occurrence despite a high satisfaction rate with this operation. Nearly half of patients consuming ARS after LARS are taking these medications for symptoms not necessarily related to GER. These findings underscore the importance of patient education in the use of these agents.

PubMed Disclaimer

Similar articles

• Long-term outcomes of laparoscopic antireflux surgery for gastroesophageal reflux disease (GERD)-related airway disorder.
  Kaufman JA, Houghland JE, Quiroga E, Cahill M, Pellegrini CA, Oelschlager BK. Kaufman JA, et al. Surg Endosc. 2006 Dec;20(12):1824-30. doi: 10.1007/s00464-005-0329-9. Surg Endosc. 2006. PMID: 17063301
• Effectiveness of laparoscopic fundoplication in relieving the symptoms of gastroesophageal reflux disease (GERD) and eliminating antireflux medical therapy.
  Papasavas PK, Keenan RJ, Yeaney WW, Caushaj PF, Gagné DJ, Landreneau RJ. Papasavas PK, et al. Surg Endosc. 2003 Aug;17(8):1200-5. doi: 10.1007/s00464-002-8910-y. Epub 2003 May 13. Surg Endosc. 2003. PMID: 12739117 Review.
• Measuring the effectiveness of laparoscopic antireflux surgery: long-term results.
  Gee DW, Andreoli MT, Rattner DW. Gee DW, et al. Arch Surg. 2008 May;143(5):482-7. doi: 10.1001/archsurg.143.5.482. Arch Surg. 2008. PMID: 18490558
• Outcome of laparoscopic antireflux surgery in patients with nonerosive reflux disease.
  Bammer T, Freeman M, Shahriari A, Hinder RA, DeVault KR, Achem SR. Bammer T, et al. J Gastrointest Surg. 2002 Sep-Oct;6(5):730-7. doi: 10.1016/s1091-255x(02)00042-2. J Gastrointest Surg. 2002. PMID: 12399063
• Antireflux surgery.
  Gatenby PA, Bann SD. Gatenby PA, et al. Minerva Chir. 2009 Apr;64(2):169-81. Minerva Chir. 2009. PMID: 19365317 Review.

Cited by

• Evaluation of factors associated with reflux recurrence after fundoplication.
  Al Asadi H, Najah H, Marshall T, Alqamish M, Salehi N, Finnerty BM, Fahey TJ 3rd, Zarnegar R. Al Asadi H, et al. Surg Endosc. 2024 Oct 21. doi: 10.1007/s00464-024-11344-2. Online ahead of print. Surg Endosc. 2024. PMID: 39433585
• Total versus partial posterior fundoplication in the surgical repair of para-oesophageal hernias: randomized clinical trial.
  Analatos A, Lindblad M, Ansorge C, Lundell L, Thorell A, Håkanson BS. Analatos A, et al. BJS Open. 2022 May 2;6(3):zrac034. doi: 10.1093/bjsopen/zrac034. BJS Open. 2022. PMID: 35511051 Free PMC article. Clinical Trial.
• Effect of anti-reflux therapy on pulmonary function in idiopathic pulmonary fibrosis: a systematic review and meta-analysis.
  Yang M, Dong J, An J, Liu L, Chen L. Yang M, et al. J Thorac Dis. 2021 Oct;13(10):5776-5787. doi: 10.21037/jtd-21-771. J Thorac Dis. 2021. PMID: 34795926 Free PMC article.
• Association Between Laparoscopic Antireflux Surgery and Recurrence of Gastroesophageal Reflux.
  Maret-Ouda J, Wahlin K, El-Serag HB, Lagergren J. Maret-Ouda J, et al. JAMA. 2017 Sep 12;318(10):939-946. doi: 10.1001/jama.2017.10981. JAMA. 2017. PMID: 28898377 Free PMC article.
• Radiologic and endoscopic characteristics of laparoscopic antireflux wrap: correlation with outcome.
  Braghetto I, Korn O, Csendes A, Valladares H, Davanzo C, Debandi A. Braghetto I, et al. Int Surg. 2012 Jul-Sep;97(3):189-97. doi: 10.9738/CC120.1. Int Surg. 2012. PMID: 23113845 Free PMC article.

References

1. 1. JSLS. 2003 Jul-Sep;7(3):211-8 - PubMed
2. 1. Ann Surg. 1994 Oct;220(4):472-81; discussion 481-3 - PubMed
3. 1. Am J Med. 1992 May 27;92(5A):27S-32S - PubMed
4. 1. Dig Dis Sci. 1986 Feb;31(2):131-8 - PubMed
5. 1. Arch Surg. 2003 May;138(5):514-8; discussion 518-9 - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources

• Full Text Sources

  • Ovid Technologies, Inc.
  • Springer

• Medical

  • MedlinePlus Health Information