Nationwide survey of long-term results of laparoscopic antireflux surgery in Sweden

Abstract

Objective. Excellent results after laparoscopic antireflux surgery (LARS) have been reported from specialized clinics. These good results were not confirmed in a nationwide survey that studied procedures carried out in 1995–96 in Sweden. Critics pointed out that this study included the learning curve of laparoscopy. Therefore, we have repeated the survey after >5000 LARS procedures have been performed. Material and methods. A random sample of 236 patients operated on in 2000 was identified (Group I) and compared to the population operated on in 1995–96 (Group II). Both groups received a disease-specific questionnaire 4 years after surgery. Results. In Group I, 6.8% of patients had had a second procedure, 16.4% used antireflux medications regularly and 14.9% were dissatisfied. The results for Group II were 6.0%, 19.5% and 15.0%, respectively. Patients reporting any of these three conditions were classified as treatment failures. Treatment failure occurred in 25.4% and 29.0% of patients in Groups I and II, respectively. Conclusions. The nationwide long-term outcome after LARS in Sweden demonstrates that approximately a quarter of patients experience some sort of treatment failure. The results seem to be consistent, even though the surgical technique ought to be well implemented after >8years of common use.