Skip to main content
Top
Published in: Journal of Gastrointestinal Surgery 6/2009

01-06-2009 | Original Article

The Effect of Obesity on the Outcome of Laparoscopic Antireflux Surgery

Authors: Jacob A. Chisholm, Glyn G. Jamieson, Carolyn J. Lally, Peter G. Devitt, Philip A. Game, David I. Watson

Published in: Journal of Gastrointestinal Surgery | Issue 6/2009

Login to get access

Abstract

Background

Obesity has long been considered to be a predisposing factor for gastroesophageal reflux. It is also thought to predispose patients to a poorer clinical outcome following antireflux surgery. This study examined the effect of body mass index (BMI) on clinical outcomes following laparoscopic antireflux surgery.

Methods

Patients were included if they had undergone a laparoscopic fundoplication, their presurgical BMI was known, and they had been followed for at least 12 months after surgery. The clinical outcome was determined using a structured questionnaire, and this was applied yearly after surgery. Patients were divided into four groups according to BMI: normal weight (BMI < 25), overweight (BMI 25–29.9), obese (BMI 30–34.9), and morbidly obese (BMI ≥ 35). The most recent clinical outcome data was analyzed for each BMI group.

Results

Patients, 481, were studied. One hundred three (21%) had a normal BMI, 208 (43%) were overweight, 115 (24%) were obese, and 55 (12%) were morbidly obese. Mean follow-up was 7.5 years. Conversion to an open operation and requirement for revision surgery were not influenced by preoperative weight. Operating time was longer in obese patients (mean 86 vs 75 min). Clinical outcomes improved following surgery regardless of BMI.

Conclusions

Preoperative BMI does not influence the clinical outcome following laparoscopic antireflux surgery. Obesity is not a contraindication for laparoscopic fundoplication.
Literature
8.
go back to reference Watson DI, Pike GK, Baigrie RJ, Mathew G, Devitt PG, Britten-Jones R, et al. Prospective double blind randomized trial of laparoscopic Nissen fundoplication with division and without division of short gastric vessels. Ann Surg 1997;226:642–652. doi:10.1097/00000658-199711000-00009.PubMedCrossRef Watson DI, Pike GK, Baigrie RJ, Mathew G, Devitt PG, Britten-Jones R, et al. Prospective double blind randomized trial of laparoscopic Nissen fundoplication with division and without division of short gastric vessels. Ann Surg 1997;226:642–652. doi:10.​1097/​00000658-199711000-00009.PubMedCrossRef
11.
go back to reference Watson DI, Jamieson GG, Mitchell PC, Devitt PG, Britten-Jones R. Stenosis of the esophageal hiatus following laparoscopic fundoplication. Arch Surg 1995;130:1014–1016.PubMed Watson DI, Jamieson GG, Mitchell PC, Devitt PG, Britten-Jones R. Stenosis of the esophageal hiatus following laparoscopic fundoplication. Arch Surg 1995;130:1014–1016.PubMed
15.
go back to reference Revicki DA, Wood M, Wiklund I, Crawley J. Reliability and validity of the gastrointestinal symptom rating scale in patients with gastroesophageal reflux disease. Qual Life Res 1997;7:75–83. doi:10.1023/A:1008841022998.CrossRef Revicki DA, Wood M, Wiklund I, Crawley J. Reliability and validity of the gastrointestinal symptom rating scale in patients with gastroesophageal reflux disease. Qual Life Res 1997;7:75–83. doi:10.​1023/​A:​1008841022998.CrossRef
16.
go back to reference Nelson LG, Gonzalez R, Haines K, Gallagher SF, Murr MM. Amelioration of gastroesophageal reflux symptoms following Roux-en-Y gastric bypass for clinically significant obesity. Am Surg 2005;71:950–954.PubMed Nelson LG, Gonzalez R, Haines K, Gallagher SF, Murr MM. Amelioration of gastroesophageal reflux symptoms following Roux-en-Y gastric bypass for clinically significant obesity. Am Surg 2005;71:950–954.PubMed
18.
go back to reference Iovino P, Angrisani L, Tremolaterra F, Nirchio E, Ciannella M, Borrelli V, et al. Abnormal esophageal acid exposure is common in morbidly obese patients and improves after a successful Lap-Band system implantation. Surg Endosc 2002;16:1631–1635. doi:10.1007/s00464-001-90225–0.PubMedCrossRef Iovino P, Angrisani L, Tremolaterra F, Nirchio E, Ciannella M, Borrelli V, et al. Abnormal esophageal acid exposure is common in morbidly obese patients and improves after a successful Lap-Band system implantation. Surg Endosc 2002;16:1631–1635. doi:10.​1007/​s00464-001-90225–0.PubMedCrossRef
19.
go back to reference Klaus A, Gruber I, Wetscher G, Nehoda H, Aigner F, Peer R, et al. Prevalent esophageal body motility disorders underlie aggravation of GERD symptoms in morbidly obese patients following adjustable gastric banding. Arch Surg 2006;141:247–251. doi:10.1001/archsurg.141.3.247.PubMedCrossRef Klaus A, Gruber I, Wetscher G, Nehoda H, Aigner F, Peer R, et al. Prevalent esophageal body motility disorders underlie aggravation of GERD symptoms in morbidly obese patients following adjustable gastric banding. Arch Surg 2006;141:247–251. doi:10.​1001/​archsurg.​141.​3.​247.PubMedCrossRef
Metadata
Title
The Effect of Obesity on the Outcome of Laparoscopic Antireflux Surgery
Authors
Jacob A. Chisholm
Glyn G. Jamieson
Carolyn J. Lally
Peter G. Devitt
Philip A. Game
David I. Watson
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 6/2009
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-009-0837-3

Other articles of this Issue 6/2009

Journal of Gastrointestinal Surgery 6/2009 Go to the issue