{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T15:33:21Z","timestamp":1774107201293,"version":"3.50.1"},"reference-count":13,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,9,4]],"date-time":"2019-09-04T00:00:00Z","timestamp":1567555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,9,4]],"date-time":"2019-09-04T00:00:00Z","timestamp":1567555200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,9,4]],"date-time":"2019-09-04T00:00:00Z","timestamp":1567555200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Flatulence is known to be a common side effect of laparoscopic fundoplication, yet the true incidence is unclear and its impact on patients\u2019 quality of life not well understood. This study aimed to assess the long\u2010term incidence of flatulence, and its effect on quality of life, following fundoplication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients who underwent primary laparoscopic fundoplication between 1999 and 2009 were identified from a prospectively maintained institutional database. A cross\u2010sectional analysis of post\u2010operative gastrointestinal symptoms and quality of life was performed using a symptom\u2010specific questionnaire. Statistical analysis of outcomes stratified by sex and type of fundoplication was performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>462 eligible patients were identified from the database, with follow\u2010up obtained in 265 (57%). Median age at surgery was 53 (22\u201378) years. 137 patients (52%) were female. 138 (52%) underwent a 360\u00b0 fundoplication, the remainder a partial fundoplication. At median follow\u2010up of 11 (8\u201315) years, excessive flatulence was reported by 85%. Only 12% reported an adverse impact on social life, and 11% an adverse impact on quality of life. Flatulence was worse following a total than partial fundoplication, women reported more gas\u2010related symptoms than men, yet neither sex nor wrap type had a significant impact on social life or quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The majority of patients report excessive flatulence at long\u2010term follow\u2010up after anti\u2010reflux surgery, yet the impact on social life and quality life was small. There was no evidence to support tailoring of wrap type by sex to avoid gas\u2010related symptoms. The authors advocate that all patients understand the inevitable side effects of fundoplication to help manage expectations from surgery.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-05144-2","type":"journal-article","created":{"date-parts":[[2019,9,4]],"date-time":"2019-09-04T20:04:27Z","timestamp":1567627467000},"page":"3065-3073","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Flatulence After Anti\u2010reflux Treatment (FAART) Study"],"prefix":"10.1002","volume":"43","author":[{"given":"A. J.","family":"Cockbain","sequence":"first","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery Royal Adelaide Hospital Port Road 5000 Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Parameswaran","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery Royal Adelaide Hospital Port Road 5000 Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. I.","family":"Watson","sequence":"additional","affiliation":[{"name":"Flinders Medical Centre Flinders University Discipline of Surgery Adelaide Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Bright","sequence":"additional","affiliation":[{"name":"Flinders Medical Centre Flinders University Discipline of Surgery Adelaide Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. K.","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery Royal Adelaide Hospital Port Road 5000 Adelaide SA Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,9,4]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2004.051821"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.626"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f1908"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.7174"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010013\u20102959\u20107"},{"key":"e_1_2_9_7_1","first-page":"Cd003243","article-title":"Medical versus surgical management for gastro\u2010oesophageal reflux disease (GORD) in adults","volume":"3","author":"Wileman SM","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31824b31ad"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31828604dd"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2006.11.011"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182171c48"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.8870"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010015\u20104177\u2010y"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010009\u20100216\u2010y"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-019-05144-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-019-05144-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-019-05144-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-019-05144-2","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T14:59:03Z","timestamp":1703343543000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-019-05144-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,4]]},"references-count":13,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["10.1007\/s00268-019-05144-2"],"URL":"https:\/\/doi.org\/10.1007\/s00268-019-05144-2","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,4]]},"assertion":[{"value":"4 September 2019","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors have no sources of financial support or conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study was approved by the local institutional research ethics committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}