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Title: Long-term effectiveness of laparoscopic partial anterior fundoplication
Author: Porter, Victoria
ISNI:       0000 0004 2726 0531
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 2011
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Introduction: Gastro-oesophageal disease (GORD) is a common disease affecting 20% of adults in the Western world (Dexter 2004) and occurs when the anti-reflux barrier is compromised. Anti-reflux surgery can be recommended to patients with GORD as an alternate to long-term medical therapy. Aim: Laparoscopic anterior fundoplication (LAF) is the preferred type of anti-reflux surgery in our institution. This study aimed to determine the long-term effectiveness of LAF by means of quality of life (QOL) and acid reflux level assessment. Methods: After applying exclusion criteria, patients were sent an invitation for the study along with a QOL questionnaire (QOLRAD) to complete. Selected patients were also invited to undergo 24-hour pH studies. These patients were also asked to complete another QOL questionnaire (Reflux questionnaire (RQ)). Results: QOLRAD questionnaires were analysed (n = 126) and mean scores were calculated for each dimension in addition to an overall QOL score. Over 75% of patients in both the medium-term (2-4 years) and long-term groups (5-14 years) had a good QOL (score 5-7). The median QOL score for the long-term group was 5.89 (±1.36). In addition, Reflux Questionnaire QOL scores (n = 20) (RQLS) indicated that patients were well with a median score of 87.7 out of 100 at long-term. By comparing our post-operative results to published baseline result, our patients QOL had improved since surgery. Most dimensions (QOLRAD) and all symptoms scores (RQ) suggested improvement from baseline. Post-operative 24-hour pH testing (n = 22 0) showed that 55% of patients had a normal TFT pH<4 and that a further 18% had better TFT pH <4 than pre-operatively at long-term follow-up Conclusion: This study suggests that LAF is effective in the long-term by maintaining a good QOL and controlling acid reflux levels. However, larger numbers of participants and pre-operative data are required to confirm these findings.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Fundoplication ; Esophagus ; Gastroesophageal reflux