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Arch Surg. 2002;137:397-401.

Hypothesis  Patients still have symptoms following laparoscopic antireflux surgery and require ongoing treatment.

Design  Mailed survey.

Setting  Academic tertiary care center.

Patients  Of 247 consecutive adults, 197 (80% response) who underwent laparoscopic fundoplication for gastroesophageal reflux disease in the prior 1 to 5 years.

Main Outcome Measures  Gastrointestinal symptoms (frequency and bother), actions taken to treat these symptoms (medications and dietary and lifestyle changes), and assessment of surgery.

Results  The mean age of the respondents was 51.1 years, and 52% were men. The median time since surgery was 2.6 years. Overall, 28% reported typical reflux symptoms (heartburn or regurgitation), but only 5% were bothered "a lot" or "terribly" by them. While 65% reported other gastrointestinal symptoms (bloating or dysphagia) that may be related to gastroesophageal reflux disease or to surgery, only 19% were bothered a lot or terribly by them. About half of the respondents reported taking at least 1 of the following actions for their symptoms: 6% take frequent over-the-counter medications, 13% take daily prescription acid-reducing medications, 41% make lifestyle changes (eg, eating smaller meals), and 44% avoid certain foods (eg, carbonated beverages). Nevertheless, 90% believed their surgery was working well.

Conclusions  In 1 to 5 years after laparoscopic antireflux surgery, many patients report gastrointestinal symptoms and take action to control these symptoms. Most, however, believe their surgical treatment is working well.

From the Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (Drs Liu and Laycock); the VA Outcomes Group, VA Medical Center, White River Junction, Vt (Drs Liu, Woloshin, and Schwartz); and the Center for the Evaluative Clinical Sciences, Dartmouth Medical School, Hanover, NH (Drs Woloshin and Schwartz).

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