Health-Related Quality of Life 10 Years After Laparoscopic Nissen Fundoplication-Results of a Community-Based Hospital

Background: The lack of correlation between the symptomatic outcome after fundoplication and the results of objective measurements has been demonstrated. Therefore, subjective tools are needed to measure the outcomes of the treatment. Long-term results concerning health-related quality of life (HRQoL) after laparoscopic Nissen fundoplication (LNF) performed in a community-based hospital are lacking. The objective of this study was to describe HRQoL of an LNF cohort 10 years after surgery performed in a community-based hospital. Subjects and Methods: In 1997-1999, 107 LNFs were performed. The 15D questionnaire was mailed to all patients, and consent to participate in the study was requested. The patients who agreed to participate were interviewed. The resulting 15D profile and single index scores were compared with those of a sample of age-standardized general population (n=6053). Results: Of the 107 patients, 64 (59.8%) participated in the study (40 men; mean age, 61.9 years; range, 28-85 years). The mean 15D score for our patient group was 0.860 versus 0.888 for the age-standardized general population (P=.030). The mean 15D score of the patients who were satisfied with the surgical results was 0.870 (median, 0.890), which is clinically the same as that of the general population. Among the patients, dissatisfaction with the results of surgery decreased the mean 15D score by 0.069 (P=.023). Conclusions: Our long-term follow-up study suggests that, in the majority of patients, HRQoL after LNF performed in a community-based hospital is similar to that of the general population, while the subjective failure of surgery leads to suboptimal results. The multidimensional 15D instrument seems a promising HRQoL instrument also when applied to gastroesophageal reflux disease patients.