Better clinical outcomes are not just a matter of performing an indicated operative procedure well, but perhaps even more—a factor of appropriate patient selection, work-up, and pre-procedure education. This chapter adds another important factor—the need to longitudinally follow patients, measuring both objective and subjective outcomes in order to council patients, determine when re-intervention is indicated and to allow surgeons to alter and improve their technique based on their own results (continuous quality improvement).
Perhaps naturally, surgeons tend to focus on the technical aspects of procedures, and to some extent, the indications and preparations for the operation, rather than the care and follow-up of the patient. Fundoplication, however, is a functional repair of a chronic disease and, like other such surgeries (bariatric procedures and Crohn’s surgeries come to mind), it requires as much care and focus for the aftercare of the patient as is given to the preoperative evaluation and operative technique. In addition, continuous improvement of a surgeon’s outcomes in antireflux surgery comes from careful and objective surveillance of one’s results. In this chapter, we will discuss elements of postoperative care and follow-up that can affect the effectiveness of the fundoplication surgery.
Fundoplication Postoperative Follow-up GERD Surgery Endoscopy Database Manometry pH testing Quality of life
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