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01-04-2020 | Affective Disorder | 2019 SAGES Oral

Impact of psychiatric disorders on patient satisfaction after Nissen Fundoplication

Authors: Carla N. Holcomb, Noah J. Switzer, Anahita Jalilvand, Patricia Belle, Monet McNally, Kyle Perry

Published in: Surgical Endoscopy | Issue 4/2020

Abstract

Background

Anxiety and depression have been associated with an increased perception of gastroesophageal reflux symptoms, but there is a paucity of data regarding the outcomes of laparoscopic Nissen Fundoplication (LNF) in this patient population.

Methods

We performed a retrospective cohort study including all patients undergoing LNF between 2011 and 2017. Patients were stratified by baseline usage of serotonin-modulating medication or benzodiazepines as a proxy for depression and anxiety, respectively. Outcome measures included postoperative gastroesophageal health-related quality of life (GERD-HRQL) scores and overall satisfaction rates after surgery. A p value of < 0.05 was considered statistically significant.

Results

The population consisted of 271 patients of which 103 patients had depression and 44 patients had anxiety. Patients with depression reported no significant difference in pre- or postoperative GERD-HRQL scores compared to patients without depression and long-term satisfaction rates after surgery were similar in both groups at 76% vs 71%, respectively (p = 0.55). Patients with anxiety reported higher baseline HRQL scores (34 vs. 29, p = 0.05). At long-term follow-up (15 months), patients with anxiety reported slightly worse HRQL scores compared to controls (7 vs. 4, p = 0.11) despite no difference in usage of anti-acid medications or need for endoscopic dilations between the two groups. Patients with anxiety were less likely to report being “satisfied” after surgery (40% vs. 71%, p = 0.01) compared to controls.

Conclusion

Patients with anxiety have higher subjective reporting of GERD symptoms and are more likely to report being “satisfied” during long-term follow-up after LNF. Patients on medication for depression appear to have similar reporting of GERD symptoms and derive as much benefit from LNF as patients that are not. While LNF does improve the symptom burden in patients with anxiety, satisfaction is rarely achieved in long-term follow-up.

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Title: Impact of psychiatric disorders on patient satisfaction after Nissen Fundoplication
Authors: Carla N. Holcomb
Noah J. Switzer
Anahita Jalilvand
Patricia Belle
Monet McNally
Kyle Perry
Publication date: 01-04-2020
Publisher: Springer US
Keywords: Affective Disorder
Gastroesophageal Reflux Disease
Affective Disorder
Gastric Fundoplication
Gastric Fundoplication
Anxiety
Published in: Surgical Endoscopy / Issue 4/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-06949-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of psychiatric disorders on patient satisfaction after Nissen Fundoplication

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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