Alemanno Giovanni, Bergamini Carlo, Prosperi Paolo, Bruscino Alessandro, Leahu Ancuta, Somigli Riccardo, Martellucci Jacopo, Valeri Andrea
Department of Emergency, Emergency and Minimally Invasive Surgery Unit, Careggi University Hospital, Florence, Italy.
J Minim Access Surg. 2017 Jul-Sep;13(3):208-214. doi: 10.4103/0972-9941.205872.
The quality of life (QoL) has been suggested to be the most relevant parameter to assess and monitor the long-term outcome in patients who underwent surgery for gastroesophageal reflux disease (GERD).
A retrospective evaluation was conducted on patients who underwent Laparoscopic Nissen-Rossetti Fundoplication for GERD between January 1998 and December 2010. To evaluate the long-term results a telephone interview was made using the VISICK score and the GERD-health-related QoL (HRQL) questionnaire at 1, 3, 5 years and at the end of the study. If the questionnaires resulted unsatisfactory, a complete diagnostic revaluation was performed.
A total of 168 patients underwent laparoscopic surgery for GERD. When evaluated at the end of the study, the number of unsatisfied patients according to the VISICK score was significantly higher than the one obtained with the GERD-HRQL questionnaire.
Many data suggest a possible recurrence of the symptoms after surgery in a long follow-up period. Our data seem to demonstrate a slight but significant trend in symptoms relapse after surgery. Considering the non-specific and specific nature of the two scores, VISICK and GERD HRQL, our result showed a significantly more relevant trend of symptoms relapse only for the non-specific ones. Such QoL scores seem to be important in selecting patients who need to be instrumentally examined. Consequently, our work proves that only a few patients out of the total number of followed up patients, are to be recalled to undergo instrumental examination.
生活质量(QoL)被认为是评估和监测接受胃食管反流病(GERD)手术患者长期预后的最相关参数。
对1998年1月至2010年12月期间接受腹腔镜Nissen-Rossetti胃底折叠术治疗GERD的患者进行回顾性评估。为评估长期结果,在1年、3年、5年及研究结束时通过电话访谈使用VISICK评分和GERD健康相关生活质量(HRQL)问卷。如果问卷结果不理想,则进行全面的诊断重新评估。
共有168例患者接受了GERD的腹腔镜手术。在研究结束时评估时,根据VISICK评分不满意的患者数量显著高于GERD-HRQL问卷得出的数量。
许多数据表明,在长期随访期手术后症状可能复发。我们的数据似乎表明手术后症状复发有轻微但显著的趋势。考虑到VISICK和GERD HRQL这两个评分的非特异性和特异性性质,我们的结果显示仅非特异性症状复发的趋势明显更相关。此类生活质量评分在选择需要进行器械检查的患者方面似乎很重要。因此,我们的工作证明,在所有随访患者中,只有少数患者需要被召回进行器械检查。