TITLE:
Evaluation of the Quality of Life in Pre- and Post-Operatory in Patients Submitted to Surgical Treatment of Reflux Disease and Hiato Hernia
AUTHORS:
Fernando Athayde Veloso Madureira, Roosevelt Filho, Priscila Panisset Figueiredo Galvão
KEYWORDS:
GERD, Reflux Disease, Hiatal Hernia, Robotic Surgery, Minimal Invasive Surgery, Quality of Life
JOURNAL NAME:
Surgical Science,
Vol.14 No.6,
June
30,
2023
ABSTRACT: Gastroesophageal reflux disease affects 40% of the population
in industrialized countries. GERD has a negative impact on the quality of life
of affected patients. Although PPIs induce a good response in the control of
symptoms, the need for prolonged use of the medication and the fact that more
than a third of the patients have symptoms even after its correct use, make
surgery, an alternative for the treatment of the disease. The aims of this
study were to compare the quality of life related to GERD before and after MIS
surgical treatment of GERD and/or hiatus hernia, and to analyze the results and
complications of the MIS treatment of GERD. Methods: For
retrospective analysis, the electronic database of
patients with indications for surgical treatment
due to GERD and/or patients with sliding or paraesophageal hernias was
examined. The study included patients from Hospital Universitário Gaffrée e
Guinle and the Postgraduate Course in
General Surgery at PUC-Rio (Rio de Janeiro, Brazil) who underwent
surgery using video laparoscopy or robotic surgery between January 2013 and
March 2020. This is an observational, longitudinal, descriptive
study with retrospective analysis of the data. Surgical treatment was indicated
due to incomplete response to clinical treatment, young age with persistent
symptoms, or complications of GERD. Patients with hiatus and/or paraesophageal
hernia with indication for surgical treatment were included. Results: The
study evaluated 160 patients who underwent anti-reflux surgery by laparoscopic
or robotic surgery in the period from 2013 to 2020. A total of 88 women and 72
men were operated, mean 46.6 ±
13.7 years. An improvement in the preoperative QS-GERD scores compared to the
postoperative scores was observed (27.56 ± 10.93 vs 1.4 ± 2.47, p The length of hospital stay was 24 hours in 74.2% of
patients, 48 hours in 19.3%, and 72 hours in 4.6%, with a global median of 24
hours and a mean of 28.7 hours. No patient required blood transfusion; none had early
postoperative complications (seroma, wound infection, or eventration), or died. Conclusion: A significant drop in the QS-GERD score was found before and
after the surgical treatment of GERD and or hiatus hernia. The MIS surgical
treatment of GERD controlled the symptoms in most of the treated individuals,
presenting a low rate of complications without mortality.