Assessment of Outcome After Antireflux Surgery

Gastroesophageal reflux disease is common, causing chronic symptoms in many people. The medical and surgical therapies that are available and effective seem to incur a variety of side effects and long-term costs. With the development of laparoscopic surgical treatment techniques, the number of patients suggested for surgery may increase, which necessitates that an evaluation of this new treatment be conducted that compares it with the possible alternatives. This evaluation should include efficacy, safety, cost benefit, and quality of life (QOL) assessments. QOL evaluations have to be used with care. It is important that the methods are validated and found reliable for the group of patients assessed. If used in the right way, a new dimension-the patient's view-may influence the choice of treatment. For reflux, two self-administered questionnaires have been used, the Psychological General Well Being Index (PGWB) and the Gastrointestinal Symptom Rating Scale (GSRS). In reflux patients, results show poor values in untreated patients contrasted with normal values in patients who have had optimal medical treatment and patients who have had surgery. The assessments seem to be sensitive enough to discriminate between the different treatments, thereby adding important information concerning the treatment outcome.