Proceed With Caution When Operating on Female Patients With Gastro-Oesophageal Reflux!

The article by Hammerschlag et al. in this issue entitled ‘Does patient sex influence the symptom pattern for patients with gastro-oesophageal reflux disease and the response of symptoms to fundoplication?’ is a thought-provoking study worthy of further discussion.

The authors evaluated 328 patients (48% female) undergoing either a laparoscopic Nissen (360°) or Toupet (270°) fundoplication. In particular, they assessed whether there was a ‘female’ pattern of symptoms, both pre-operatively and post-operatively, which led to decreased satisfaction following surgery. They found that bloating, asthma, constipation, and diarrhoea were reported significantly more often by females prior to surgery. Contrary to their hypothesis, the type of fundoplication (total vs. partial) did not influence the outcome for these symptoms...