Abstract
IntroductionImproving health-related quality of life (HRQoL) is increasingly recognized as an essential part of patient care outcome. Little is known about the effect of laparoscopic antireflux surgery (LARS) on the HRQoL in the pediatric patients. The aims of this study were to evaluate the effect of LARS on HRQoL in children with gastroesophageal reflux disease (GERD) and to identify predictors that influence HRQoL outcome after LARS.MethodsBetween 2011 and 2013, 25 patients with therapy-resistant GERD [median age 6 (2–18) years] were included prospectively. Caregivers and children with normal neurodevelopment (>4 years) were asked to fill out the validated PedsQL 4.0 Generic Core Scales before and 3–4 months after LARS.ResultsThe PedsQL was completed by all caregivers (n = 25) and 12 children. HRQoL total score improved significantly after LARS, both from a parental (p = 0.009) and child’s perspective (p = 0.018). The psychosocial health summary and physical health summary scores also improved significantly after LARS. HRQoL before and after LARS was significantly lower in children with impaired neurodevelopment (p < 0.001). However, neurodevelopment did not influence the effect of LARS on HRQoL. The only significant predictor for improvement in HRQoL after LARS was age at the time of operation (p = 0.001).ConclusionsHRQoL significantly improves after LARS. Although children with impaired neurodevelopment had lower overall HRQoL, neurodevelopment by itself does not predict inferior improvement in HRQoL after LARS. Older children have a more favorable HRQoL outcome after LARS compared to younger children. This may suggest caution when considering LARS in younger GERD patients.
Highlights
Improving health-related quality of life (HRQoL) is increasingly recognized as an essential part of patient care outcome
HRQoL before and after laparoscopic antireflux surgery (LARS) was significantly lower in children with impaired neurodevelopment (p \ 0.001)
Preoperative gastric emptying rate, total acid exposure time and reflux symptoms did not significantly influence the change in HRQoL (Table 4). This is the first study on HRQoL in children undergoing LARS that used a validated pediatric HRQoL questionnaire [6, 13,14,15,16,17]
Summary
Improving health-related quality of life (HRQoL) is increasingly recognized as an essential part of patient care outcome. Little is known about the effect of laparoscopic antireflux surgery (LARS) on the HRQoL in the pediatric patients. The aims of this study were to evaluate the effect of LARS on HRQoL in children with gastroesophageal reflux disease (GERD) and to identify predictors that influence HRQoL outcome after LARS. Methods Between 2011 and 2013, 25 patients with therapy-resistant GERD [median age 6 (2–18) years] were included prospectively. Caregivers and children with normal neurodevelopment ([4 years) were asked to fill out the validated PedsQL 4.0 Generic Core Scales before and 3–4 months after LARS
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