O190 THE EPIDEMIOLOGY OF ANTI-REFLUX SURGERY IN DENMARK 2000-2017: A NATIONWIDE REGISTRY-BASED POPULATION STUDY
| Autor: | Jesper Durup, Jonas Sanberg Ljungdalh, Kim Christian Houlind |
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| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | Diseases of the Esophagus. 32 |
| ISSN: | 1442-2050 2000-2017 |
| DOI: | 10.1093/dote/doz092.190 |
| Popis: | Aim The primary aim of this register-based study was to describe the utilization and development of anti-reflux surgery compared to use of proton-pump inhibitors from 2000-2017 in a nationwide population-based cohort. Background & Methods Treatment of GERD consists of anti-secretory drugs, mainly proton pump inhibitors (PPI), or anti-reflux surgery. Laparoscopic anti-reflux surgery is considered standard of care in surgical treatment of gastro-esophageal reflux disease1 and with careful patient selection based on thorough preoperative workup2 symptom control and patient satisfaction are high compared to medical therapy3–5. In American studies, the rate of anti-reflux surgery peaked at 16.7 per 100.000 inhabitants in 2000 and then decreased to 6.1 per 100.000 inhabitants by 20106, 7. The only Danish study on the epidemiology of anti-reflux surgery, describes a reoperation rate of 5%, but only includes data from 1997-2005 and describes no rate of surgery compared to population size8. It is therefore unclear how the use of anti-reflux surgery has developed. This register-based cohort study includes all patients who have undergone anti-reflux surgery in Denmark from 2000-2017. Data was retrieved from The National Danish Patient Registry and linked at an individual level using the unique civil registration number issued to all Danes. For the entire study period, rate of anti-reflux surgery, including primary and reoperative procedures, Charlson comorbidity index (CCI), 30- and 90-days perioperative mortality, use of laparoscopic technique and length of stay was calculated. Population-based rates of surgery was compared to rates of PPI-use. Results Rate of surgery peaked between 2000-2005 with >5.0 procedures per 100.000 inhabitants, but declined consistenly in the rest of the study period. Reoperations were an increasing percentage of the prodecures with up to 20% increasing from 7%. CCI increased during the study period with >25% having a CCI>0 at the end of the study. In the entire period, >98% of procedures were performed laparoscopically, mortality Conclusion Anti-reflux surgery was utilized less, but mortality, conversion rates and length of hospital stay were consistently low, despite an increased burden of comorbidity and reoperations. |
| Databáze: | OpenAIRE |
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