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Reflux disease without mucosal damage: is there a place for surgery?
G G Jamieson1, C J O'Boyle, D I Watson
1Department of Surgery, University of Adelaide, Royal Adelaide Hospital, SA, Australia.
Chest Surgery Clinics of North America
|January 15, 2002
Summary
Antireflux surgery can effectively treat regurgitation and heartburn, even without visible esophageal damage. Laparoscopic antireflux surgery offers a cure for reflux symptoms, regardless of endoscopic findings.
Area of Science:
- Gastroenterology
- Surgical Innovation
Background:
- Regurgitation often necessitates antireflux surgery, irrespective of esophageal mucosal damage.
- Heartburn severity does not reliably correlate with the degree of esophageal mucosal damage.
- Laparoscopic antireflux surgery has significantly reduced morbidity, increasing patient interest in definitive reflux cures.
Purpose of the Study:
- To evaluate the efficacy of laparoscopic antireflux surgery in patients with problematic regurgitation.
- To determine if endoscopic evidence of esophageal mucosal damage is a prerequisite for successful antireflux surgery.
Main Methods:
- Review of existing literature on antireflux surgery outcomes.
- Analysis of patient data comparing outcomes with and without endoscopic mucosal damage.
- Focus on laparoscopic antireflux procedures.
Main Results:
- Patients with significant regurgitation benefit from antireflux surgery, irrespective of mucosal damage.
- Laparoscopic antireflux surgery provides successful outcomes for symptom cure in this patient group.
- Esophageal mucosal damage is not essential for successful antireflux surgery.
Conclusions:
- Laparoscopic antireflux surgery is an effective treatment for problematic regurgitation and heartburn.
- The presence or absence of endoscopic esophageal mucosal damage does not preclude successful surgical outcomes.
- An "acid-sensitive esophagus" is not currently an established indication for this surgical intervention.