TBD Meeting (3725-19)

BALTIMORE – A staging scale developed by the bariatric team at the University of Alberta has shown potential as a tool to accurately predict major complications 1 year after Roux-en-Y gastric bypass (RYGB) surgery, surpassing the predictability of body mass index alone, a researcher reported at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons.

monkeybusinessimages/Thinkstock

Researchers at the university validated the predictive utility of the scale, known as the Edmonton Obesity Staging System (EOSS), in a retrospective chart review of 378 patients who had RYGB between December 2009 and November 2015 at Royal Alexandra Hospital in Edmonton, Alt. The EOSS uses a scale from 0 to 4 to score a patient’s risk for complications: the higher the score, the greater the risk of complications.

“The EOSS may help determine risk of major complications after RYGB, and, given its overall simplicity, you can also think of it as analogous to the American Society of Anesthesiologists physical status classification system or the New York Heart Association classification system for congestive heart failure,” said Samuel Skulsky, a 3rd-year medical student at the University of Alberta. “It may have utility as well in communicating to patients their overall risk.”

A previous study applied the EOSS score to the National Health and Human Nutrition Examination Survey to compare it to use of body mass index (BMI) as a predictive marker of mortality (CMAJ. 2011;183:E1059-66). Where the four BMI classifications were clustered on the Kaplan-Meier between 0.7 and 0.9 at 200 months post examination, the four EOSS stages analyzed, 0-3, showed more of a spread, from around 0.55 for stage 3 to near 1.0 for stage 0. This gave the researchers the idea that EOSS could also be used to predict morbidity and mortality specifically in obese patients scheduled for surgery, Mr. Skulsky said. “With the Kaplan-Meier survival curves, the EOSS actually nicely stratifies the patients with their overall survival,” he said. “In comparison, BMI did not do as well in stratifying overall mortality.”

The study reported the following 1-year complication rates in the EOSS stages:

• Stage 0 (n = 14), 7.1%.
• Stage 1 (n = 41), 4.9%.
• Stage 2 (n = 297), 8.8%.
• Stage 3 (n = 26), 23.1%.

There were no stage 4 patients in the study population.

SOURCE: Skulsky SL et al. SAGES 2019, Session SS12.

BALTIMORE – A staging scale developed by the bariatric team at the University of Alberta has shown potential as a tool to accurately predict major complications 1 year after Roux-en-Y gastric bypass (RYGB) surgery, surpassing the predictability of body mass index alone, a researcher reported at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons.

monkeybusinessimages/Thinkstock

Researchers at the university validated the predictive utility of the scale, known as the Edmonton Obesity Staging System (EOSS), in a retrospective chart review of 378 patients who had RYGB between December 2009 and November 2015 at Royal Alexandra Hospital in Edmonton, Alt. The EOSS uses a scale from 0 to 4 to score a patient’s risk for complications: the higher the score, the greater the risk of complications.

“The EOSS may help determine risk of major complications after RYGB, and, given its overall simplicity, you can also think of it as analogous to the American Society of Anesthesiologists physical status classification system or the New York Heart Association classification system for congestive heart failure,” said Samuel Skulsky, a 3rd-year medical student at the University of Alberta. “It may have utility as well in communicating to patients their overall risk.”

A previous study applied the EOSS score to the National Health and Human Nutrition Examination Survey to compare it to use of body mass index (BMI) as a predictive marker of mortality (CMAJ. 2011;183:E1059-66). Where the four BMI classifications were clustered on the Kaplan-Meier between 0.7 and 0.9 at 200 months post examination, the four EOSS stages analyzed, 0-3, showed more of a spread, from around 0.55 for stage 3 to near 1.0 for stage 0. This gave the researchers the idea that EOSS could also be used to predict morbidity and mortality specifically in obese patients scheduled for surgery, Mr. Skulsky said. “With the Kaplan-Meier survival curves, the EOSS actually nicely stratifies the patients with their overall survival,” he said. “In comparison, BMI did not do as well in stratifying overall mortality.”

The study reported the following 1-year complication rates in the EOSS stages:

• Stage 0 (n = 14), 7.1%.
• Stage 1 (n = 41), 4.9%.
• Stage 2 (n = 297), 8.8%.
• Stage 3 (n = 26), 23.1%.

There were no stage 4 patients in the study population.

SOURCE: Skulsky SL et al. SAGES 2019, Session SS12.

BALTIMORE – A staging scale developed by the bariatric team at the University of Alberta has shown potential as a tool to accurately predict major complications 1 year after Roux-en-Y gastric bypass (RYGB) surgery, surpassing the predictability of body mass index alone, a researcher reported at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons.

monkeybusinessimages/Thinkstock

Researchers at the university validated the predictive utility of the scale, known as the Edmonton Obesity Staging System (EOSS), in a retrospective chart review of 378 patients who had RYGB between December 2009 and November 2015 at Royal Alexandra Hospital in Edmonton, Alt. The EOSS uses a scale from 0 to 4 to score a patient’s risk for complications: the higher the score, the greater the risk of complications.

“The EOSS may help determine risk of major complications after RYGB, and, given its overall simplicity, you can also think of it as analogous to the American Society of Anesthesiologists physical status classification system or the New York Heart Association classification system for congestive heart failure,” said Samuel Skulsky, a 3rd-year medical student at the University of Alberta. “It may have utility as well in communicating to patients their overall risk.”

A previous study applied the EOSS score to the National Health and Human Nutrition Examination Survey to compare it to use of body mass index (BMI) as a predictive marker of mortality (CMAJ. 2011;183:E1059-66). Where the four BMI classifications were clustered on the Kaplan-Meier between 0.7 and 0.9 at 200 months post examination, the four EOSS stages analyzed, 0-3, showed more of a spread, from around 0.55 for stage 3 to near 1.0 for stage 0. This gave the researchers the idea that EOSS could also be used to predict morbidity and mortality specifically in obese patients scheduled for surgery, Mr. Skulsky said. “With the Kaplan-Meier survival curves, the EOSS actually nicely stratifies the patients with their overall survival,” he said. “In comparison, BMI did not do as well in stratifying overall mortality.”

The study reported the following 1-year complication rates in the EOSS stages:

• Stage 0 (n = 14), 7.1%.
• Stage 1 (n = 41), 4.9%.
• Stage 2 (n = 297), 8.8%.
• Stage 3 (n = 26), 23.1%.

There were no stage 4 patients in the study population.

SOURCE: Skulsky SL et al. SAGES 2019, Session SS12.

BALTIMORE – Most male surgeons welcome and support their female colleagues in the workplace, but a survey of male surgeons reports that bias against women in surgery persists, and may be even more acute among younger surgeons, according to a presentation at the annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons.

“Is there a bias against women in surgery?” asked Michalina Jadick, who presented the results on behalf of AdventHealth Hospital Tampa. “Yes, there is, and understanding this problem is imperative when learning how to fix it.”

A freshman at Boston University who conducted the survey of male surgeons as part of a mentoring program for young women at AdventHealth, Ms. Jadick reported on results of an online survey completed by 190 male surgeons. She noted that, while women represent more than 50% of medical school students, they constitute only 19% of general surgeons in the United States. “Especially in the face of a projected shortage of practicing surgeons, it is more important now than ever to investigate, understand, and work to eliminate the barriers encountered by this large and unique talent pool,” she said.

The anonymous survey was extensive, including 70 five-point Likert-scale questions and 63 multiple choice and binary answers. Regarding the male surgeons who completed the survey, 84% were attendings with more than 5 years of experience, and 8% had less than 5 years in surgery. The remainder were residents, fellows and interns.

When asked if women are as capable as their male counterparts, 80% agreed, with the remainder split between “disagree” or “no opinion.”

“Although this is very small in comparison, that’s actually pretty significant,” Ms. Jadick said of the 10% who disagreed.

When asked if women make good surgeons, 67% agreed, 10% disagreed, and 23% selected neither. “We found that older male surgeons were more likely to believe women make successful surgeons, as opposed to younger male doctors,” Ms. Jadick said. She called this finding “surprising” because younger doctors are expected to have more progressive ideas. “However, this response seems to indicate otherwise, and that’s an important part of the conversation.”

When asked if women have the same advancement opportunities as men, 75% agreed and 9% disagreed. When the question was flipped – that is, if men have more opportunities than women – 32% agreed and 43% disagreed. Half of responders concurred that women are discouraged from entering surgery because program directors question their ability to complete surgical training, yet 95% agreed that men and women residents receive equal training. “This is especially a problem,” Ms. Jadick said of the latter finding.

The survey also found wide disparities in how male surgeons feel about family roles. A high percentage – 80% – agreed that a woman can be both a good surgeon and a good parent. But an even higher percentage – 96% – said a man could be good in both roles. “When looking at the disagreement to these statements, 13% said it is not possible for a woman to be both a good surgeon and a good parent, while not one single male respondent said the same for men,” Ms. Jadick said. Of the men surveyed, 84% agreed that female surgeons are under greater pressure than men to balance work and family life.

Exploring the family issue even deeper, 46% of the respondents said that having children adversely affects a female surgeon professionally, whereas only 9% said the same of men. Conversely, 31% said children do not affect a female surgeon’s career, but 81% said children do not affect a male surgeon’s career.

“Clearly the topic of family obligations is a huge issue in the context of gender discrimination against women in surgery, and this is the case even though many have indicated that women and men have similar commitment to families outside of work,” Ms. Jadick said. “This has proven to be a big part of the issue in the past and likely moving forward as well. That’s why it’s of paramount importance for us to take this into consideration and understand that it’s happening.”

When asked about working with women in the operating room, 20% of male respondents agreed that women surgeons are aggressive coworkers, and 19% said that it’s easier to work with male colleagues. This attitude may be a function of the stereotype of women being deferential to leadership rather than assuming it, she said.

When asked frankly if discrimination exists in surgery today, 43% answered “yes” – but 57% said “no” or “unsure.”

“This finding clearly portrays the problem does persist in surgery, and therefore, it’s very important for [male] surgeons in particular to remain aware of that problem and actively work to eliminate that disparity within that work environment,” Ms. Jadick said.

However, the 57% who said discrimination is not a problem is more unsettling, she said. “That’s incredibly significant because the first step to solving any problem is recognizing that there is one,” Ms. Jadick said. “However, then we must commit to solving it. Only by promoting an equitable and inclusive work environment that promotes the engagement of women can we improve the future of surgery for the betterment of all of its stakeholders, especially patients.”

Ms. Jadick had no financial relationships to disclose.

BALTIMORE – Most male surgeons welcome and support their female colleagues in the workplace, but a survey of male surgeons reports that bias against women in surgery persists, and may be even more acute among younger surgeons, according to a presentation at the annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons.

“Is there a bias against women in surgery?” asked Michalina Jadick, who presented the results on behalf of AdventHealth Hospital Tampa. “Yes, there is, and understanding this problem is imperative when learning how to fix it.”

A freshman at Boston University who conducted the survey of male surgeons as part of a mentoring program for young women at AdventHealth, Ms. Jadick reported on results of an online survey completed by 190 male surgeons. She noted that, while women represent more than 50% of medical school students, they constitute only 19% of general surgeons in the United States. “Especially in the face of a projected shortage of practicing surgeons, it is more important now than ever to investigate, understand, and work to eliminate the barriers encountered by this large and unique talent pool,” she said.

The anonymous survey was extensive, including 70 five-point Likert-scale questions and 63 multiple choice and binary answers. Regarding the male surgeons who completed the survey, 84% were attendings with more than 5 years of experience, and 8% had less than 5 years in surgery. The remainder were residents, fellows and interns.

When asked if women are as capable as their male counterparts, 80% agreed, with the remainder split between “disagree” or “no opinion.”

“Although this is very small in comparison, that’s actually pretty significant,” Ms. Jadick said of the 10% who disagreed.

When asked if women make good surgeons, 67% agreed, 10% disagreed, and 23% selected neither. “We found that older male surgeons were more likely to believe women make successful surgeons, as opposed to younger male doctors,” Ms. Jadick said. She called this finding “surprising” because younger doctors are expected to have more progressive ideas. “However, this response seems to indicate otherwise, and that’s an important part of the conversation.”

When asked if women have the same advancement opportunities as men, 75% agreed and 9% disagreed. When the question was flipped – that is, if men have more opportunities than women – 32% agreed and 43% disagreed. Half of responders concurred that women are discouraged from entering surgery because program directors question their ability to complete surgical training, yet 95% agreed that men and women residents receive equal training. “This is especially a problem,” Ms. Jadick said of the latter finding.

The survey also found wide disparities in how male surgeons feel about family roles. A high percentage – 80% – agreed that a woman can be both a good surgeon and a good parent. But an even higher percentage – 96% – said a man could be good in both roles. “When looking at the disagreement to these statements, 13% said it is not possible for a woman to be both a good surgeon and a good parent, while not one single male respondent said the same for men,” Ms. Jadick said. Of the men surveyed, 84% agreed that female surgeons are under greater pressure than men to balance work and family life.

Exploring the family issue even deeper, 46% of the respondents said that having children adversely affects a female surgeon professionally, whereas only 9% said the same of men. Conversely, 31% said children do not affect a female surgeon’s career, but 81% said children do not affect a male surgeon’s career.

“Clearly the topic of family obligations is a huge issue in the context of gender discrimination against women in surgery, and this is the case even though many have indicated that women and men have similar commitment to families outside of work,” Ms. Jadick said. “This has proven to be a big part of the issue in the past and likely moving forward as well. That’s why it’s of paramount importance for us to take this into consideration and understand that it’s happening.”

When asked about working with women in the operating room, 20% of male respondents agreed that women surgeons are aggressive coworkers, and 19% said that it’s easier to work with male colleagues. This attitude may be a function of the stereotype of women being deferential to leadership rather than assuming it, she said.

When asked frankly if discrimination exists in surgery today, 43% answered “yes” – but 57% said “no” or “unsure.”

“This finding clearly portrays the problem does persist in surgery, and therefore, it’s very important for [male] surgeons in particular to remain aware of that problem and actively work to eliminate that disparity within that work environment,” Ms. Jadick said.

However, the 57% who said discrimination is not a problem is more unsettling, she said. “That’s incredibly significant because the first step to solving any problem is recognizing that there is one,” Ms. Jadick said. “However, then we must commit to solving it. Only by promoting an equitable and inclusive work environment that promotes the engagement of women can we improve the future of surgery for the betterment of all of its stakeholders, especially patients.”

Ms. Jadick had no financial relationships to disclose.

BALTIMORE – Most male surgeons welcome and support their female colleagues in the workplace, but a survey of male surgeons reports that bias against women in surgery persists, and may be even more acute among younger surgeons, according to a presentation at the annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons.

“Is there a bias against women in surgery?” asked Michalina Jadick, who presented the results on behalf of AdventHealth Hospital Tampa. “Yes, there is, and understanding this problem is imperative when learning how to fix it.”

A freshman at Boston University who conducted the survey of male surgeons as part of a mentoring program for young women at AdventHealth, Ms. Jadick reported on results of an online survey completed by 190 male surgeons. She noted that, while women represent more than 50% of medical school students, they constitute only 19% of general surgeons in the United States. “Especially in the face of a projected shortage of practicing surgeons, it is more important now than ever to investigate, understand, and work to eliminate the barriers encountered by this large and unique talent pool,” she said.

The anonymous survey was extensive, including 70 five-point Likert-scale questions and 63 multiple choice and binary answers. Regarding the male surgeons who completed the survey, 84% were attendings with more than 5 years of experience, and 8% had less than 5 years in surgery. The remainder were residents, fellows and interns.

When asked if women are as capable as their male counterparts, 80% agreed, with the remainder split between “disagree” or “no opinion.”

“Although this is very small in comparison, that’s actually pretty significant,” Ms. Jadick said of the 10% who disagreed.

When asked if women make good surgeons, 67% agreed, 10% disagreed, and 23% selected neither. “We found that older male surgeons were more likely to believe women make successful surgeons, as opposed to younger male doctors,” Ms. Jadick said. She called this finding “surprising” because younger doctors are expected to have more progressive ideas. “However, this response seems to indicate otherwise, and that’s an important part of the conversation.”

When asked if women have the same advancement opportunities as men, 75% agreed and 9% disagreed. When the question was flipped – that is, if men have more opportunities than women – 32% agreed and 43% disagreed. Half of responders concurred that women are discouraged from entering surgery because program directors question their ability to complete surgical training, yet 95% agreed that men and women residents receive equal training. “This is especially a problem,” Ms. Jadick said of the latter finding.

The survey also found wide disparities in how male surgeons feel about family roles. A high percentage – 80% – agreed that a woman can be both a good surgeon and a good parent. But an even higher percentage – 96% – said a man could be good in both roles. “When looking at the disagreement to these statements, 13% said it is not possible for a woman to be both a good surgeon and a good parent, while not one single male respondent said the same for men,” Ms. Jadick said. Of the men surveyed, 84% agreed that female surgeons are under greater pressure than men to balance work and family life.

Exploring the family issue even deeper, 46% of the respondents said that having children adversely affects a female surgeon professionally, whereas only 9% said the same of men. Conversely, 31% said children do not affect a female surgeon’s career, but 81% said children do not affect a male surgeon’s career.

“Clearly the topic of family obligations is a huge issue in the context of gender discrimination against women in surgery, and this is the case even though many have indicated that women and men have similar commitment to families outside of work,” Ms. Jadick said. “This has proven to be a big part of the issue in the past and likely moving forward as well. That’s why it’s of paramount importance for us to take this into consideration and understand that it’s happening.”

When asked about working with women in the operating room, 20% of male respondents agreed that women surgeons are aggressive coworkers, and 19% said that it’s easier to work with male colleagues. This attitude may be a function of the stereotype of women being deferential to leadership rather than assuming it, she said.

When asked frankly if discrimination exists in surgery today, 43% answered “yes” – but 57% said “no” or “unsure.”

“This finding clearly portrays the problem does persist in surgery, and therefore, it’s very important for [male] surgeons in particular to remain aware of that problem and actively work to eliminate that disparity within that work environment,” Ms. Jadick said.

However, the 57% who said discrimination is not a problem is more unsettling, she said. “That’s incredibly significant because the first step to solving any problem is recognizing that there is one,” Ms. Jadick said. “However, then we must commit to solving it. Only by promoting an equitable and inclusive work environment that promotes the engagement of women can we improve the future of surgery for the betterment of all of its stakeholders, especially patients.”

Ms. Jadick had no financial relationships to disclose.

BALTIMORE – Patients who take benzodiazepines for anxiety and have laparoscopic Nissen fundoplication for gastroesophageal reflux disease achieve similar outcomes as other patients, but also have much lower rates of postop satisfaction, according to a study from the Ohio State University presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons.

DAJ/Thinkstock

Carla Holcomb, MD, a minimally invasive surgery/bariatric fellow at the Ohio State’s Wexner Medical Center, Columbus, reported the upshot of the study findings. “Preoperative counseling is especially important regarding postoperative expectations in patients with anxiety,” she said.

The retrospective study evaluated 271 patients who had laparoscopic Nissen fundoplication (LNF) during 2011-2016 at the medical center, comparing outcomes in patients who were on serotonin-modulating medication for depression (n = 103), benzodiazepines for anxiety (n = 44), or neither (n = 124). The researchers evaluated a number of metrics – DeMeester score of esophageal acid exposure, pre- and postoperative health-related quality of life, and postoperative antacid use and need for endoscopic dilation – across all cohorts. While some scores among the anxiety cohort trended higher (DeMeester score of 43 vs. 38 for the no-anxiety patients) they were not statistically significant, Dr. Holcomb noted. Patients taking antidepressants reported similar subjective outcomes and satisfaction rates to those not taking antidepressants.

However, when patients were queried about their overall satisfaction after laparoscopic Nissen fundoplication 77%-87% in the no-depression, depression, and no-anxiety groups reported they were satisfied, while only 37% of those in the anxiety group did so. That is based on a response rate of 53% to a telephone inquiry 15 months after LNF.

“The patients who had anxiety looked vastly different from the rest of the population,” said Dr. Holcomb. “Patients taking antidepressants reported similar objective outcomes and high satisfaction rates, [compared with] patients not taking antidepressants after LNF, and although LNF does improve gastroesophageal reflux disease symptoms in patients taking anxiolytics, they rarely achieve satisfaction in long-term follow-up.”

Among the study limitations Dr. Holcomb acknowledged were the 53% long-term response rate and not knowing if an anatomical reason may explain the higher health-related quality of life scores in the anxiety group – 7 vs. 4 in the no-anxiety group – at long-term follow-up, although the overall score was low at 5.

Dr. Holcomb had no relevant financial disclosures.

SOURCE: Holcomb CN et al. SAGES 2019, Session SS04.

BALTIMORE – Patients who take benzodiazepines for anxiety and have laparoscopic Nissen fundoplication for gastroesophageal reflux disease achieve similar outcomes as other patients, but also have much lower rates of postop satisfaction, according to a study from the Ohio State University presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons.

DAJ/Thinkstock

Carla Holcomb, MD, a minimally invasive surgery/bariatric fellow at the Ohio State’s Wexner Medical Center, Columbus, reported the upshot of the study findings. “Preoperative counseling is especially important regarding postoperative expectations in patients with anxiety,” she said.

The retrospective study evaluated 271 patients who had laparoscopic Nissen fundoplication (LNF) during 2011-2016 at the medical center, comparing outcomes in patients who were on serotonin-modulating medication for depression (n = 103), benzodiazepines for anxiety (n = 44), or neither (n = 124). The researchers evaluated a number of metrics – DeMeester score of esophageal acid exposure, pre- and postoperative health-related quality of life, and postoperative antacid use and need for endoscopic dilation – across all cohorts. While some scores among the anxiety cohort trended higher (DeMeester score of 43 vs. 38 for the no-anxiety patients) they were not statistically significant, Dr. Holcomb noted. Patients taking antidepressants reported similar subjective outcomes and satisfaction rates to those not taking antidepressants.

However, when patients were queried about their overall satisfaction after laparoscopic Nissen fundoplication 77%-87% in the no-depression, depression, and no-anxiety groups reported they were satisfied, while only 37% of those in the anxiety group did so. That is based on a response rate of 53% to a telephone inquiry 15 months after LNF.

“The patients who had anxiety looked vastly different from the rest of the population,” said Dr. Holcomb. “Patients taking antidepressants reported similar objective outcomes and high satisfaction rates, [compared with] patients not taking antidepressants after LNF, and although LNF does improve gastroesophageal reflux disease symptoms in patients taking anxiolytics, they rarely achieve satisfaction in long-term follow-up.”

Among the study limitations Dr. Holcomb acknowledged were the 53% long-term response rate and not knowing if an anatomical reason may explain the higher health-related quality of life scores in the anxiety group – 7 vs. 4 in the no-anxiety group – at long-term follow-up, although the overall score was low at 5.

Dr. Holcomb had no relevant financial disclosures.

SOURCE: Holcomb CN et al. SAGES 2019, Session SS04.

BALTIMORE – Patients who take benzodiazepines for anxiety and have laparoscopic Nissen fundoplication for gastroesophageal reflux disease achieve similar outcomes as other patients, but also have much lower rates of postop satisfaction, according to a study from the Ohio State University presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons.

DAJ/Thinkstock

Carla Holcomb, MD, a minimally invasive surgery/bariatric fellow at the Ohio State’s Wexner Medical Center, Columbus, reported the upshot of the study findings. “Preoperative counseling is especially important regarding postoperative expectations in patients with anxiety,” she said.

The retrospective study evaluated 271 patients who had laparoscopic Nissen fundoplication (LNF) during 2011-2016 at the medical center, comparing outcomes in patients who were on serotonin-modulating medication for depression (n = 103), benzodiazepines for anxiety (n = 44), or neither (n = 124). The researchers evaluated a number of metrics – DeMeester score of esophageal acid exposure, pre- and postoperative health-related quality of life, and postoperative antacid use and need for endoscopic dilation – across all cohorts. While some scores among the anxiety cohort trended higher (DeMeester score of 43 vs. 38 for the no-anxiety patients) they were not statistically significant, Dr. Holcomb noted. Patients taking antidepressants reported similar subjective outcomes and satisfaction rates to those not taking antidepressants.

However, when patients were queried about their overall satisfaction after laparoscopic Nissen fundoplication 77%-87% in the no-depression, depression, and no-anxiety groups reported they were satisfied, while only 37% of those in the anxiety group did so. That is based on a response rate of 53% to a telephone inquiry 15 months after LNF.

“The patients who had anxiety looked vastly different from the rest of the population,” said Dr. Holcomb. “Patients taking antidepressants reported similar objective outcomes and high satisfaction rates, [compared with] patients not taking antidepressants after LNF, and although LNF does improve gastroesophageal reflux disease symptoms in patients taking anxiolytics, they rarely achieve satisfaction in long-term follow-up.”

Among the study limitations Dr. Holcomb acknowledged were the 53% long-term response rate and not knowing if an anatomical reason may explain the higher health-related quality of life scores in the anxiety group – 7 vs. 4 in the no-anxiety group – at long-term follow-up, although the overall score was low at 5.

Dr. Holcomb had no relevant financial disclosures.

SOURCE: Holcomb CN et al. SAGES 2019, Session SS04.