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A poor response to proton pump inhibition is not a contraindication for laparoscopic antireflux surgery for gastro esophageal reflux disease.

Wilkerson PM, Stratford J, Jones L, Sohanpal J, Booth MI, Dehn TC

Department of Laparoscopic and Upper GI Surgery, Royal Berkshire Hospital, London Road, Reading RG1 5AN, England, UK. PMWilkerson@aol.com

BACKGROUND: We aimed to determine if a poor response to proton pump inhibitors (PPIs) can predict a poor outcome following laparoscopic antireflux surgery (LARS) in our surgically treated population. METHODS: A total of 324 patients undergoing LARS were included in this study. Following standardized assessment, patients recorded the efficacy of their medication on visual analogue scales. Pre- and postoperative symptom scores were recorded, with outcomes measured by modified Visick scores. RESULTS: There were 233 good responders (>50% relief) and 91 poor responders (<49% relief). Both groups demonstrated a significant decline in postoperative symptom scores. Ninety-four percent of good responders had an excellent or good outcome, compared to 87% of poor responders. Twenty-seven patients reported a fair or poor outcome, despite improved postoperative symptom scores. Fifteen of these patients reported continuing heartburn; five had positive pH tests. CONCLUSION: Our results do not support the assumption that a poor response to PPIs equates to a poor outcome after LARS.

Published 26 October 2005 in Surg Endosc, 19(9): 1272-7.
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