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Gastroesophageal Reflux Disease II: Clinical Features and Management

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Related Experiment Video

Updated: Jun 24, 2026

Technical Considerations and Approach to Redo Foregut Surgery
04:14

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Published on: September 22, 2023

Antireflux surgery.

P A C Gatenby1, Simon D Bann

  • 1Division of Surgery and Interventional Science, University College London Medical School, Royal Free Campus, London, UK. p.gatenby@ucl.ac.uk

Minerva Chirurgica
|April 15, 2009
PubMed
Summary
This summary is machine-generated.

Antireflux surgery for gastro-esophageal reflux disease (GERD) is safe and effective, comparable to proton pump inhibitors. However, long-term failure rates and cost-effectiveness limit its recommendation over medical therapy.

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Area of Science:

  • Gastroenterology
  • Surgical Science

Background:

  • Gastro-esophageal reflux disease (GERD) is a prevalent condition in Europe and the US.
  • Medical management includes histamine H2 receptor antagonists and proton pump inhibitors.

Purpose of the Study:

  • To review the evidence for surgical treatment of GERD.
  • Compare surgical outcomes with medical antireflux therapy.

Main Methods:

  • Systematic review of randomized trials and cohort studies on GERD treatments.
  • Analysis of laparoscopic versus open antireflux surgery and medical therapy.

Main Results:

  • Laparoscopic antireflux surgery demonstrates safety and efficacy comparable to open surgery and proton pump inhibitors.
  • Significant failure rates (over 50% at 5 years) exist for antireflux surgery.
  • Total fundoplication offers better reflux control but increases dysphagia risk.
  • Antireflux surgery shows a non-significant trend towards superior cancer prevention in Barrett's esophagus.

Conclusions:

  • Antireflux surgery is a safe and effective GERD treatment option.
  • Cost-effectiveness analysis does not favor surgery over proton pump inhibitors.
  • Procedure choice involves balancing reflux control and side effects like dysphagia.