A poor response to proton pump inhibition is not a contraindication for laparoscopic antireflux surgery for gastro esophageal reflux disease

Surg Endosc. 2005 Sep;19(9):1272-7. doi: 10.1007/s00464-004-2238-8. Epub 2005 Jul 14.


Background: We aimed to determine if a poor response to proton pump inhibitors (PPIs) can predict a poor outcome following laparoscopic antireflux surgery (LARS) in our surgically treated population.

Methods: A total of 324 patients undergoing LARS were included in this study. Following standardized assessment, patients recorded the efficacy of their medication on visual analogue scales. Pre- and postoperative symptom scores were recorded, with outcomes measured by modified Visick scores.

Results: There were 233 good responders (>50% relief) and 91 poor responders (<49% relief). Both groups demonstrated a significant decline in postoperative symptom scores. Ninety-four percent of good responders had an excellent or good outcome, compared to 87% of poor responders. Twenty-seven patients reported a fair or poor outcome, despite improved postoperative symptom scores. Fifteen of these patients reported continuing heartburn; five had positive pH tests.

Conclusion: Our results do not support the assumption that a poor response to PPIs equates to a poor outcome after LARS.

MeSH terms

  • Adult
  • Contraindications
  • Female
  • Follow-Up Studies
  • Gastroesophageal Reflux / drug therapy*
  • Gastroesophageal Reflux / surgery*
  • Humans
  • Laparoscopy*
  • Male
  • Middle Aged
  • Proton Pump Inhibitors*


  • Proton Pump Inhibitors