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Gas and Bloat in Female Patients after Antireflux Procedures: Analysis of 934 Cases.
- Source :
-
Journal of the American College of Surgeons [J Am Coll Surg] 2024 Jul 01; Vol. 239 (1), pp. 18-29. Date of Electronic Publication: 2024 Apr 26. - Publication Year :
- 2024
-
Abstract
- Background: Antireflux procedures (ARPs) are effective treatments for GERD. However, variation in objective and patient-reported outcomes persists. Limited evidence and anecdotal experience suggest that patient sex may play a role. The objective of this study was to compare outcomes after ARPs between male and female patients.<br />Study Design: We performed a retrospective review of a prospectively maintained database at a single institution. All patients who underwent an ARP for GERD were included. Demographic, clinical, and patient-reported outcomes data (GERD health-related quality of life [HRQL] and reflux symptom index), and radiographic hernia recurrence were collected and stratified by sex. Univariable and multivariable logistic and mixed-effects linear regression were used to control for confounding effects.<br />Results: Between 2009 and 2022, 934 patients (291 men and 643 women) underwent an ARP. Reflux symptom index, GERD-HRQL, and gas and bloat scores improved uniformly for both sexes, though female patients were more likely to have higher gas and bloat scores 1 year postprocedure (mean ± SD 1.7 ± 1.4 vs 1.4 ± 1.3, p = 0.03) and higher GERD-HRQL scores 2 years postprocedure (6.3 ± 8.1 vs 4.7 ± 6.8, p = 0.04). Higher gas and bloat scores in women persisted on regression controlling for confounders. Hernia recurrence rate was low (85 patients, 9%) and was similar for both sexes. A final intraprocedural distensibility index 3 mm 2 /mmHg or more was significantly associated with a 7 times higher rate of recurrence (95% CI 1.62 to 31.22, p = 0.01).<br />Conclusions: Although patients of either sex experience symptom improvement and low rate of recurrence after ARPs, women are more likely to endorse gas and bloat compared with men. Final distensibility index 3 mm 2 /mmHg or more carries a high risk of recurrence. These results may augment how physicians prognosticate during consultation and tailor their treatment in patients with GERD.<br /> (Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)
- Subjects :
- Humans
Female
Male
Middle Aged
Retrospective Studies
Sex Factors
Recurrence
Adult
Fundoplication methods
Quality of Life
Aged
Postoperative Complications epidemiology
Postoperative Complications etiology
Patient Reported Outcome Measures
Treatment Outcome
Hernia, Hiatal complications
Hernia, Hiatal diagnosis
Hernia, Hiatal surgery
Gastroesophageal Reflux diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1190
- Volume :
- 239
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of the American College of Surgeons
- Publication Type :
- Academic Journal
- Accession number :
- 38666653
- Full Text :
- https://doi.org/10.1097/XCS.0000000000001102