Skip to main content
Erschienen in: Journal of Gastrointestinal Surgery 3/2008

01.03.2008 | original article

Use of Antireflux Medication After Antireflux Surgery

verfasst von: Bas P. L. Wijnhoven, Carolyn J. Lally, John J. Kelly, Jennifer C. Myers, David I. Watson

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 3/2008

Einloggen, um Zugang zu erhalten

Abstract

Introduction

It is claimed that a substantial number of patients who undergo antireflux surgery use antireflux medication postoperatively. This study was aimed to determine the prevalence and underlying reasons for antireflux medication usage in patients after surgery.

Materials and Methods

A questionnaire on the usage of antireflux medication was sent to 1,008 patients identified from a prospective database of patients who had undergone a laparoscopic antireflux procedure.

Results

A total of 844 patients (84%) returned the questionnaire. Mean follow-up was 5.9 years after surgery. A single or combination of medications was being taken by 312 patients (37%): 82% proton pump inhibitors, 9% H2-blockers and 34% antacids. Fifty-two patients (17%) had never stopped taking medication, whereas 260 patients (83%) restarted medication at a mean of 2.5 years after surgery. Return of the same (31%) or different (49%) symptoms were the commonest reasons for taking medication, whereas 20% were asymptomatic or had other reasons for medication use. Postoperative 24-hour pH studies were abnormal in 16/61 patients (26%) on medication and in 5/78 patients (6%) not taking medication.

Conclusions

Antireflux medication is frequently taken by many patients for various symptoms after antireflux surgery. Symptomatic patients should be properly investigated before antireflux medications are prescribed.
Literatur
1.
Zurück zum Zitat Watson DI, Jamieson GG, Devitt PG, Kennedy JA, Ellis T, Ackroyd R, Lafullarde T, Game PA. A prospective randomized trial of laparoscopic Nissen fundoplication with anterior vs posterior hiatal repair. Arch Surg 2001;136:745–751.PubMedCrossRef Watson DI, Jamieson GG, Devitt PG, Kennedy JA, Ellis T, Ackroyd R, Lafullarde T, Game PA. A prospective randomized trial of laparoscopic Nissen fundoplication with anterior vs posterior hiatal repair. Arch Surg 2001;136:745–751.PubMedCrossRef
2.
Zurück zum Zitat Bammer T, Hinder RA, Klaus A, Klingler PJ. Five- to eight-year outcome of the first laparoscopic Nissen fundoplications. J Gastrointest Surg 2001;5:42–48.PubMedCrossRef Bammer T, Hinder RA, Klaus A, Klingler PJ. Five- to eight-year outcome of the first laparoscopic Nissen fundoplications. J Gastrointest Surg 2001;5:42–48.PubMedCrossRef
3.
Zurück zum Zitat Vakil N, Shaw M, Kirby R. Clinical effectiveness of laparoscopic fundoplication in a U.S. community. Am J Med 2003;114:1–5.PubMedCrossRef Vakil N, Shaw M, Kirby R. Clinical effectiveness of laparoscopic fundoplication in a U.S. community. Am J Med 2003;114:1–5.PubMedCrossRef
4.
Zurück zum Zitat Bonatti H, Bammer T, Achem SR, Lukens F, Devault KR, Klaus A, Hinder RA. Use of Acid suppressive medications after laparoscopic antireflux surgery: prevalence and clinical indications. Dig Dis Sci 2007;52:267–272.PubMedCrossRef Bonatti H, Bammer T, Achem SR, Lukens F, Devault KR, Klaus A, Hinder RA. Use of Acid suppressive medications after laparoscopic antireflux surgery: prevalence and clinical indications. Dig Dis Sci 2007;52:267–272.PubMedCrossRef
5.
Zurück zum Zitat Bloomston M, Nields W, Rosemurgy AS. Symptoms and antireflux medication use following laparoscopic Nissen fundoplication: Outcome at 1 and 4 years. J Soc Laparoendosc Surg 2003;7:211–218. Bloomston M, Nields W, Rosemurgy AS. Symptoms and antireflux medication use following laparoscopic Nissen fundoplication: Outcome at 1 and 4 years. J Soc Laparoendosc Surg 2003;7:211–218.
6.
Zurück zum Zitat Rice S, Watson DI, Lally CJ, Devitt PG, Game PA, Jamieson GG. Laparoscopic anterior 180 degrees partial fundoplication: five-year results and beyond. Arch Surg 2006;141:271–275.PubMedCrossRef Rice S, Watson DI, Lally CJ, Devitt PG, Game PA, Jamieson GG. Laparoscopic anterior 180 degrees partial fundoplication: five-year results and beyond. Arch Surg 2006;141:271–275.PubMedCrossRef
7.
Zurück zum Zitat Papasavas PK, Keenan RJ, Yeaney WW, Caushaj PF, Gagne DJ, Landreneau RJ. Effectiveness of laparoscopic fundoplication in relieving the symptoms of gastroesophageal reflux disease (GERD) and eliminating antireflux medical therapy. Surg Endosc 2003;17:1200–1205.PubMedCrossRef Papasavas PK, Keenan RJ, Yeaney WW, Caushaj PF, Gagne DJ, Landreneau RJ. Effectiveness of laparoscopic fundoplication in relieving the symptoms of gastroesophageal reflux disease (GERD) and eliminating antireflux medical therapy. Surg Endosc 2003;17:1200–1205.PubMedCrossRef
8.
Zurück zum Zitat Lundell L, Miettinen P, Myrvold HE, Pedersen SA, Liedman B, Hatlebakk JG, Julkonen R, Levander K, Carlsson J, Lamm M, Wiklund I. Continued (5-year) follow-up of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease. J Am Coll Surg 2001;192:172–179; discussion 179–181.PubMedCrossRef Lundell L, Miettinen P, Myrvold HE, Pedersen SA, Liedman B, Hatlebakk JG, Julkonen R, Levander K, Carlsson J, Lamm M, Wiklund I. Continued (5-year) follow-up of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease. J Am Coll Surg 2001;192:172–179; discussion 179–181.PubMedCrossRef
9.
Zurück zum Zitat Lafullarde T, Watson DI, Jamieson GG, Myers JC, Game PA, Devitt PG. Laparoscopic Nissen fundoplication: Five-year results and beyond. Arch Surg 2001;136:180–184.PubMedCrossRef Lafullarde T, Watson DI, Jamieson GG, Myers JC, Game PA, Devitt PG. Laparoscopic Nissen fundoplication: Five-year results and beyond. Arch Surg 2001;136:180–184.PubMedCrossRef
10.
Zurück zum Zitat Draaisma WA, Rijnhart-de Jong HG, Broeders IA, Smout AJ, Furnee EJ, Gooszen HG. Five-year subjective and objective results of laparoscopic and conventional Nissen fundoplication: a randomized trial. Ann Surg 2006;244:34–41.PubMedCrossRef Draaisma WA, Rijnhart-de Jong HG, Broeders IA, Smout AJ, Furnee EJ, Gooszen HG. Five-year subjective and objective results of laparoscopic and conventional Nissen fundoplication: a randomized trial. Ann Surg 2006;244:34–41.PubMedCrossRef
11.
Zurück zum Zitat Lord RV, Kaminski A, Oberg S, Bowrey DJ, Hagen JA, DeMeester SR, Sillin LF, Peters JH, Crookes PF, DeMeester TR. Absence of gastroesophageal reflux disease in a majority of patients taking acid suppression medications after Nissen fundoplication. J Gastrointest Surg 2002;6:3–9; discussion 10.PubMedCrossRef Lord RV, Kaminski A, Oberg S, Bowrey DJ, Hagen JA, DeMeester SR, Sillin LF, Peters JH, Crookes PF, DeMeester TR. Absence of gastroesophageal reflux disease in a majority of patients taking acid suppression medications after Nissen fundoplication. J Gastrointest Surg 2002;6:3–9; discussion 10.PubMedCrossRef
12.
Zurück zum Zitat Galvani C, Fisichella PM, Gorodner MV, Perretta S, Patti MG. Symptoms are a poor indicator of reflux status after fundoplication for gastroesophageal reflux disease: role of esophageal functions tests. Arch Surg 2003;138:514–518; discussion 518–519.PubMedCrossRef Galvani C, Fisichella PM, Gorodner MV, Perretta S, Patti MG. Symptoms are a poor indicator of reflux status after fundoplication for gastroesophageal reflux disease: role of esophageal functions tests. Arch Surg 2003;138:514–518; discussion 518–519.PubMedCrossRef
13.
Zurück zum Zitat Jamieson GG, Watson DI, Britten-Jones R, Mitchell PC, Anvari M. Laparoscopic Nissen fundoplication. Ann Surg 1994;220:137–145.PubMedCrossRef Jamieson GG, Watson DI, Britten-Jones R, Mitchell PC, Anvari M. Laparoscopic Nissen fundoplication. Ann Surg 1994;220:137–145.PubMedCrossRef
14.
Zurück zum Zitat Krysztopik RJ, Jamieson GG, Devitt PG, Watson DI. A further modification of fundoplication. 90 degrees anterior fundoplication. Surg Endosc 2002;16:1446–1451.PubMedCrossRef Krysztopik RJ, Jamieson GG, Devitt PG, Watson DI. A further modification of fundoplication. 90 degrees anterior fundoplication. Surg Endosc 2002;16:1446–1451.PubMedCrossRef
15.
Zurück zum Zitat Watson DI, Liu JF, Devitt PG, Game PA, Jamieson GG. Outcome of laparoscopic anterior 180-degree partial fundoplication for gastroesophageal reflux disease. J Gastrointest Surg 2000;4:486–492.PubMedCrossRef Watson DI, Liu JF, Devitt PG, Game PA, Jamieson GG. Outcome of laparoscopic anterior 180-degree partial fundoplication for gastroesophageal reflux disease. J Gastrointest Surg 2000;4:486–492.PubMedCrossRef
16.
Zurück zum Zitat Australian Government DoHaA. Schedule of Pharmaceutical Benefits for Approved Pharmacists and Medical Practitioners. Australia: Australian Government, Department of Health and Ageing, 2006. Australian Government DoHaA. Schedule of Pharmaceutical Benefits for Approved Pharmacists and Medical Practitioners. Australia: Australian Government, Department of Health and Ageing, 2006.
17.
Zurück zum Zitat Khaitan L, Ray WA, Holzman MD, Smalley WE. Health care utilization after medical and surgical therapy for gastroesophageal reflux disease: A population-based study, 1996 to 2000. Arch Surg 2003;138:1356–1361.PubMedCrossRef Khaitan L, Ray WA, Holzman MD, Smalley WE. Health care utilization after medical and surgical therapy for gastroesophageal reflux disease: A population-based study, 1996 to 2000. Arch Surg 2003;138:1356–1361.PubMedCrossRef
18.
Zurück zum Zitat Dominitz JA, Dire CA, Billingsley KG, Todd-Stenberg JA. Complications and antireflux medication use after antireflux surgery. Clin Gastroenterol Hepatol 2006;4:299–305.PubMedCrossRef Dominitz JA, Dire CA, Billingsley KG, Todd-Stenberg JA. Complications and antireflux medication use after antireflux surgery. Clin Gastroenterol Hepatol 2006;4:299–305.PubMedCrossRef
19.
Zurück zum Zitat O’Boyle CJ, Watson DI, DeBeaux AC, Jamieson GG. Preoperative prediction of long-term outcome following laparoscopic fundoplication. Aust NZ J Surg 2002;72:471–475.CrossRef O’Boyle CJ, Watson DI, DeBeaux AC, Jamieson GG. Preoperative prediction of long-term outcome following laparoscopic fundoplication. Aust NZ J Surg 2002;72:471–475.CrossRef
20.
Zurück zum Zitat Jenkinson AD, Kadirkamanathan SS, Scott SM, Yazaki E, Evans DF. Relationship between symptom response and oesophageal acid exposure after medical and surgical treatment for gastro-oesophageal reflux disease. Br J Surg 2004;91:1460–1465.PubMedCrossRef Jenkinson AD, Kadirkamanathan SS, Scott SM, Yazaki E, Evans DF. Relationship between symptom response and oesophageal acid exposure after medical and surgical treatment for gastro-oesophageal reflux disease. Br J Surg 2004;91:1460–1465.PubMedCrossRef
21.
Zurück zum Zitat Khajanchee YS, O’Rourke RW, Lockhart B, Patterson EJ, Hansen PD, Swanstrom LL. Postoperative symptoms and failure after antireflux surgery. Arch Surg 2002;137:1008–1013; discussion 1013–1004.PubMedCrossRef Khajanchee YS, O’Rourke RW, Lockhart B, Patterson EJ, Hansen PD, Swanstrom LL. Postoperative symptoms and failure after antireflux surgery. Arch Surg 2002;137:1008–1013; discussion 1013–1004.PubMedCrossRef
22.
Zurück zum Zitat Velanovich V. Nonsurgical factors affecting symptomatic outcomes of antireflux surgery. Dis Esophagus 2006;19:1–4.PubMedCrossRef Velanovich V. Nonsurgical factors affecting symptomatic outcomes of antireflux surgery. Dis Esophagus 2006;19:1–4.PubMedCrossRef
23.
Zurück zum Zitat Scheffer RC, Gooszen HG, Wassenaar EB, Samsom M. Relationship between partial gastric volumes and dyspeptic symptoms in fundoplication patients: A 3D ultrasonographic study. Am J Gastroenterol 2004;99:1902–1909.PubMedCrossRef Scheffer RC, Gooszen HG, Wassenaar EB, Samsom M. Relationship between partial gastric volumes and dyspeptic symptoms in fundoplication patients: A 3D ultrasonographic study. Am J Gastroenterol 2004;99:1902–1909.PubMedCrossRef
24.
Zurück zum Zitat Scheffer RC, Samsom M, Frakking TG, Smout AJ, Gooszen HG. Long-term effect of fundoplication on motility of the oesophagus and oesophagogastric junction. Br J Surg 2004;91:1466–1472.PubMedCrossRef Scheffer RC, Samsom M, Frakking TG, Smout AJ, Gooszen HG. Long-term effect of fundoplication on motility of the oesophagus and oesophagogastric junction. Br J Surg 2004;91:1466–1472.PubMedCrossRef
25.
Zurück zum Zitat Wijnhoven BP, Salet GA, Roelofs JM, Smout AJ, Akkermans LM, Gooszen HG. Function of the proximal stomach after Nissen fundoplication. Br J Surg 1998;85:267–271.PubMedCrossRef Wijnhoven BP, Salet GA, Roelofs JM, Smout AJ, Akkermans LM, Gooszen HG. Function of the proximal stomach after Nissen fundoplication. Br J Surg 1998;85:267–271.PubMedCrossRef
26.
Zurück zum Zitat Guillemot F, Ducrotte P, Bueno L. Prevalence of functional gastrointestinal disorders in a population of subjects consulting for gastroesophageal reflux disease in general practice. Gastroenterol Clin Biol 2005;29:243–246.PubMedCrossRef Guillemot F, Ducrotte P, Bueno L. Prevalence of functional gastrointestinal disorders in a population of subjects consulting for gastroesophageal reflux disease in general practice. Gastroenterol Clin Biol 2005;29:243–246.PubMedCrossRef
27.
Zurück zum Zitat Spechler SJ, Lee E, Ahnen D, Goyal RK, Hirano I, Ramirez F, Raufman JP, Sampliner R, Schnell T, Sontag S, Vlahcevic ZR, Young R, Williford W. Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease: Follow-up of a randomized controlled trial. JAMA 2001;285:2331–2338.PubMedCrossRef Spechler SJ, Lee E, Ahnen D, Goyal RK, Hirano I, Ramirez F, Raufman JP, Sampliner R, Schnell T, Sontag S, Vlahcevic ZR, Young R, Williford W. Long-term outcome of medical and surgical therapies for gastroesophageal reflux disease: Follow-up of a randomized controlled trial. JAMA 2001;285:2331–2338.PubMedCrossRef
Metadaten
Titel
Use of Antireflux Medication After Antireflux Surgery
verfasst von
Bas P. L. Wijnhoven
Carolyn J. Lally
John J. Kelly
Jennifer C. Myers
David I. Watson
Publikationsdatum
01.03.2008
Verlag
Springer-Verlag
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 3/2008
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-007-0443-1

Weitere Artikel der Ausgabe 3/2008

Journal of Gastrointestinal Surgery 3/2008 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.