Original Article

Laparoscopic Nissen Fundoplication in a Community Hospital: Patient Satisfaction Survey

Authors: Leslie E. Tucker, MD, Carl Blatt MD, Norbert L. Richardson, MD, Donna T. Richardson, MD, James D. Cassat, MD, Thomas B. Riechers, MD

Abstract

Objectives: To assess the efficacy of laparoscopic Nissen fundoplication for esophageal reflux in a community hospital.


Methods: One hundred nineteen patients (76%) of 157 patients having laparoscopic fundoplication for symptomatic reflux disease completed a questionnaire. All patients were evaluated with esophagoscopy, esophageal motility, and pH studies.


Results: Mean follow-up was 49 months. Ninety-three patients (78%) no longer had heartburn. Seven patients still had daily heartburn (5.9%). One hundred three patients (86.6%) had no sour regurgitation. Seventy-five patients (63%) had no dysphagia after surgery. Forty-two patients had some dysphagia after surgery (36.8%). Six patients (5.0%) had significant dysphagia. Only 4 patients stated that dysphagia interfered with their quality of life. Twenty-six patients (22.8%) thought that belching and bloating were worse, whereas 42 patients (36.8%) thought that belching and bloating were better after surgery. Antacids, histamine-2 antagonist, and proton pump inhibitors were still being used by 12.6%, 14.3%, and 21.8% of patients, respectively.


Conclusions: Eighty-seven patients were completely satisfied (73.1%), 26 patients somewhat satisfied (22.8%), and 6 patients unsatisfied (5.3%) with surgery. Overall satisfaction with the surgery was 94.7%. One hundred five patients (88.2%) would recommend the surgery to others. Laparoscopic Nissen fundoplication can be effectively done in a community hospital setting.


Key Points


* A patient survey revealed laparoscopic Nissen to be effective treatment for esophageal reflux.


* Overall patient satisfaction with surgery was 95%.


* Seventy-eight percent of patients no longer had heartburn, and 87% of patients no longer had regurgitation.


* Proton pump inhibitors were still being used by 22% of patients following surgery.


* Laparoscopic Nissen fundoplication can be effectively done in a community hospital setting.

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