Univariate and multivariate analyses of preoperative factors influencing symptomatic outcomes of transoral fundoplication
| Autor: | Erik B. Wilson, William E. Barnes, Katherine D. Freeman, Peter G. Mavrelis, Brian DaCosta Gill, David Dargis, Mark G. Hausmann, Karim S. Trad, Bart J. Carter, Glenn M. Ihde, Tanja Gunsberger, Robert W. Sewell, Mark A. Fox, Kevin M. Hoddinott, Reginald Bell |
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| Jazyk: | angličtina |
| Předmět: |
Male
Multivariate analysis Fundoplication Gastroenterology Heartburn Recurrence Esophagitis Prospective Studies Laparoscopy Prospective cohort study Aged 80 and over medicine.diagnostic_test Age Factors Regurgitation Middle Aged humanities Treatment Outcome Gastroesophageal reflux Female medicine.symptom Adult Reoperation EsophyX medicine.medical_specialty Article Young Adult Esophagus Internal medicine medicine Humans Hernia Aged Refractory business.industry Proton Pump Inhibitors GERD Hepatology TIF medicine.disease digestive system diseases Surgery Hernia Hiatal Multivariate Analysis Quality of Life business Abdominal surgery |
| Zdroj: | Surgical Endoscopy |
| ISSN: | 0930-2794 |
| DOI: | 10.1007/s00464-014-3557-z |
| Popis: | Background Preoperative factors predicting symptomatic improvement after transoral fundoplication (TF) in chronic gastroesophageal reflux disease (GERD) patients with persistent symptoms on proton-pump inhibitors (PPIs) therapy have not been elucidated fully. Methods Univariate and multivariate logistic regression analyses were performed on data from 158 consecutive patients who underwent TF with the EsophyX device between January 2010 and June 2012 in 14 community centers. Variables included age, gender, body mass index, GERD duration, PPIs therapy duration, presence of hiatal hernia, esophagitis, Hill grade, quality of life scores (QOL) on PPIs, % total time pH 13 on PPIs (OR = 2.4, CI = 1.1–5.2, p = 0.027), and Gastroesophageal Reflux Symptom Score ≥ 18 on PPIs (OR = 2.6, CI = 1.2–5.8, p = 0.018). Age and GERD-HRQL score remained significant predictors by multivariate analysis. For patients with atypical symptoms, only GERD-HRQL score ≥ 15 on PPIs (OR = 9.9, CI = 0.9–4.6, p = 0.036) was associated with successful outcomes. Conclusions Elevated preoperative QOL scores on PPIs and age ≥ 50 were most closely associated with successful outcome of TF in patients with persistent symptoms despite medical therapy. |
| Databáze: | OpenAIRE |
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