Imperial College London
Alternate

Professor the Lord Darzi of Denham PC KBE FRS FMedSci HonFREng

Faculty of Medicine, Department of Surgery & Cancer

Co-Director of the IGHI, Professor of Surgery
 
 
 
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Contact

 

+44 (0)20 3312 1310a.darzi

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Markar:2020:10.1097/SLA.0000000000003131,
author = {Markar, SR and Arhi, C and Wiggins, T and Vidal-Diez, A and Karthikesalingam, A and Darzi, A and Lagergren, J and Hanna, GB},
doi = {10.1097/SLA.0000000000003131},
journal = {Annals of Surgery},
pages = {709--715},
title = {Reintervention after antireflux surgery for gastroesophageal reflux disease in England},
url = {http://dx.doi.org/10.1097/SLA.0000000000003131},
volume = {271},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: After antireflux surgery, highly variable rates of recurrent gastroesophageal reflux disease (GERD) have been reported. OBJECTIVE: To identify the occurrence and risk factors of recurrent GERD requiring surgical reintervention or medication. METHODS: The Hospital Episode Statistics database was used to identify adults in England receiving primary antireflux surgery for GERD in 2000 to 2012 with follow-up through 2014, and the outcome was surgical reintervention. In a subset of participants, the Clinical Practice Research Datalink was additionally used to assess proton pump inhibitor therapy for at least 6 months (medical reintervention). Risk factors were assessed using multivariable Cox regression providing adjusted hazard ratios (HRs) with 95% confidence intervals (95% CIs). RESULTS: Among 22,377 patients who underwent primary antireflux surgery in the Hospital Episode Statistics dataset, 811 (3.6%) had surgical reintervention, with risk factors being age 41 to 60 years (HR = 1.22, 95% CI 1.03-1.44), female sex (HR = 1.5; 95% CI 1.3-1.74), white ethnicity (HR = 1.71, 95% CI 1.06-2.77), and low hospital annual volume of antireflux surgery (HR = 1.32, 95% CI 1.04-1.67). Among 2005 patients who underwent primary antireflux surgery in the Clinical Practice Research Datalink dataset, 189 (9.4%) had surgical reintervention and 1192 (59.5%) used proton pump inhibitor therapy, with risk factors for the combined outcome being age >60 years (HR = 2.38, 95% CI 1.81-3.13) and preoperative psychiatric morbidity (HR = 1.58, 95% CI 1.25-1.99). CONCLUSION: At least 3.6% of patients may require surgical reintervention and 59.5% medical therapy following antireflux surgery in England. The influence of patient characteristics and hospital volume highlights the need for patient selection and surgical experience in successful antireflux surgery.
AU  - Markar,SR
AU  - Arhi,C
AU  - Wiggins,T
AU  - Vidal-Diez,A
AU  - Karthikesalingam,A
AU  - Darzi,A
AU  - Lagergren,J
AU  - Hanna,GB
DO  - 10.1097/SLA.0000000000003131
EP  - 715
PY  - 2020///
SN  - 0003-4932
SP  - 709
TI  - Reintervention after antireflux surgery for gastroesophageal reflux disease in England
T2  - Annals of Surgery
UR  - http://dx.doi.org/10.1097/SLA.0000000000003131
UR  - https://www.ncbi.nlm.nih.gov/pubmed/30499807
UR  - http://hdl.handle.net/10044/1/65367
VL  - 271
ER  -
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