A Nissen-féle fundoplicatio sikeressége és az azt befolyásoló faktorok. Eredmények a Pécsi Tudományegyetemen az indikációk és tünetek függvényében

Abstract

Abstract: Introduction: Gastroesophageal reflux disease is one of the most common gastrointestinal diseases in developed countries. Besides the conservative modalities, surgery plays an increasing role in the treatment of the disease. Aim: Our aim was to investigate and compare the surgical and 6-month follow-up data of patients to the literature (quality control), who underwent Nissen fundoplication in the Medical Centre of Pécs between 2007 and 2014, and to assess the factors (especially psychiatric comorbidity and antidepressants) influencing the success. Method: In summary, data of 183 fundoplications of 166 patients were collected from the medical database of the University of Pécs. Statistical analysis: For data analysis, descriptive statistical methods (relative frequency) and odds ratio with 95% confidence interval were used. Results: The most frequent indication of fundoplications was hiatal hernia combined with the failure of conservative (proton-pump inhibitor, PPI) treatment (54%). Reoperation rate (8%) was similar to literature data (5–10%). 62% of the patients had postoperative complaints, which, except bloating, were more common among women. 93.67% experienced certain grade of improvement of reflux symptoms. Postoperative PPI treatment was necessary in 37% of patients and in 9% postoperative interventions had to be performed. Female gender and psychiatric comorbidity worsened, antidepressant medication improved the success rate. The results of reoperations were inferior compared to primary operations. Conclusions: Our results suggest that the success rate of fundoplications in our centre fits to the literature data and adequate antidepressant medication may improve the worse results of psychiatric patients postoperatively, however, more randomized clinical studies are needed in this issue. Orv Hetil. 2018; 159(25): 1013–1023.