Preoperative Factors Affecting Health Quality Of Patients Undergone Surgery For Gastroesophageal Reflux Disease

Yıl 2017, Cilt: 31 Sayı: 1, 19 - 24, 26.05.2017

Turgut Anuk Şahin Kahramanca , Ali Cihat Yıldırım Mahmut Can Yağmurdur

Öz

Objective: GORD(Gastroesophageal reflux disease)is
described as reflux of gastric content to esophagus leading to retrosternal
burn more than twice in a week.Cases resistant to anti-acid therapy and who
were complicated are candidates for anti-reflux surgery.In this study our aim
is to show and analyze preoperative factors affecting SF36 health survey scores
of patients undergone Laparoscopic Nissen Fundoplication(LNF) surgery for GORD
at postoperative sixth month.

Material and method: Patients who had
complaints of pain located on epigastric region,retrosternal burn and were
diagnosed as GORD,were undergone LNF;whose data of Helicobacter pylori(HP)
positivity,alkalen reflux gastritis(ARG) positivity,body mass
indices(BMI),diameters of hiatal hernia(HH) were recorded.27 patients were
excluded from the study who didn’t fill out the SF36 form, had some missing
information in their registration or follow-up files,and undergone conversion
fundoplication or retro surgery.The effects of these factors on SF36 Health
Survey form were analyzed on postoperative sixth month and compared.

Results: 22 patients had HP,19 patients had ARG
positivity.27 patients had BMI’s between 35-39.9kg/m².Female
patients had more sensitivity to pain(p=0,041),however patients with HP
positivity had more disability of emotional role statistically(p=0,039).There
was not statistically significant in SF36 form of patients with ARG
positivity(p>0.05).Patients with wider HH tent to have more response for
physical functions and pain(p=0.039, p=0.037). Patients with BMI’s between 30-34.9
kg/m2 tent to have more response to pain(p<0.001).

Conclusion: Our results show that LNF surgery could be
successfully performed for GORD treatment and SF36 test could be useful in
evaluation of surgical quality of GORD patients undergone LNF surgery especially
who have low BMI’s and large hiatal hernia.

Anahtar Kelimeler

Gastroesophageal reflux disease, Laparoscopic Nissen Fundoplication, SF36 scores

Gastro özefageal reflü hastalığı (GÖRH) cerrahisinde yaşam kalitesine etki eden preoperatif faktörler

Öz

Amaç: Mide içeriğinin, haftada ikiden fazla günde
özofagusa kaçarak retrosternal yanmaya yol açması, gastroözofageal reflü
hastalığı (GÖRH) olarak adlandırılır. Antiasit tedaviye direnç gösteren ve
komplikasyon gelişen olgularda anti reflü cerrahi uygulanmaktadır.
Çalışmamızda, GÖRH saptanıp, Laparoskopik Nissen Fundoplikasyonu (LNF) yapılan
hastalarda, postoperatif 6. ayda hasta tarafından doldurulan yaşam kalite
ölçeği (SF 36) skorlarına etki eden preoperatif faktörleri ortaya koymayı
amaçladık.

Gereç ve yöntem: Polikliniğe epigastrik bölgede ağrı,
retrosternal yanma şikayetleriyle başvurarak GÖRH tanısı alan ve LNF uygulanan
69 hastanın dosyasından yaş, cinsiyet, Helicobacter pylori (HP), alkalen reflü
gastrit (ARG) pozitifliği, vücut kitle indeksleri (VKİ), hiatus herni (HH)
çapları kaydedildi. SF 36 formunu doldurmayan, dosya kayıtlarında ve
takiplerinde eksiklik bulunan, konversiyon fundoplikasyon ve redo surgery
uygulanan 27 hasta çalışma dışı bırakıldı. Bu özelliklerin, postoperatif
altıncı ay SF 36 formlarındaki yaşam kalitesine etkileri incelendi.

Bulgular: Çalışmamızda 22 hastada HP, 19 hastada ARG
pozitifliği saptandı. Yirmi yedi hastada VKİ 35-39,9 kg/m2 olarak hesaplandı.
Kadın cinsiyette ağrıya yanıtın daha yüksek olduğu (p=0,041) olduğu
gözlenirken, HP pozitifliği olan grupta duygusal rol kısıtlılığında azalma (p=0,039)
daha anlamlıydı. ARG pozitifliği saptanan hastalarda, SF 36 formunda anlamlı
değişiklik gözlenmedi (p>0,05). HH çapı incelendiğinde, fiziksel fonksiyon
ve ağrıya, daha geniş HH’si olan hastalarda daha yüksek oranda yanıt alındığı
gözlendi (p= 0,039 ve p= 0,037). VKİ 30-34,9 kg/m2 arası olan grupta ağrıya
yanıtın daha iyi olduğu gözlendi (p<0,001).

Sonuç: Düşük VKİ’ye sahip, geniş hiatal hernisi
olan ve LNF uygulanan GÖRH’li hastalarda uygulanan cerrahinin
değerlendirilmesinde SF 36 yaşam kalite indeksinin kullanılabileceği ve
uygulanan LNF’nin başarılı sonuç verdiği sonucuna ulaştık.

Anahtar Kelimeler

Gastroözefageal reflü hastalığı, Laparoskopik Nissen fundoplikasyonu, SF 36 skoru

Kaynakça

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